Gly rcptr alpha1 igg srm/csf — 366 bundling rules
If your bill lists 0431U alongside any of these codes as separate charges, it may be an unbundling error.
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
Common unbundling errors — medical procedures
Unbundling occurs when medical providers bill two separate codes for services that should be combined into a single charge according to National Correct Coding Initiative (NCCI) rules. In other procedures including anesthesia, radiology, pathology, and miscellaneous support services, common unbundling patterns include separately billing diagnostic imaging with its professional interpretation when both should be included in one comprehensive code, and charging for basic monitoring or preparation services alongside the primary procedure when these components are considered integral parts of the main service. Another frequent error involves billing multiple pathology examination codes for what constitutes a single comprehensive analysis. With 809 other codes subject to bundling restrictions in the NCCI database, these errors create charges above the benchmark for patients who receive multiple bills for what should constitute one complete service. The potential difference between unbundled billing and correct coding practices can significantly impact patient financial responsibility, as they may face duplicate charges for components of care that medical coding standards define as a single billable service.
What to check on your bill
When reviewing itemized bills for procedure bundling issues, patients should examine several key areas to identify potential billing irregularities. Look for multiple procedure codes billed on the same date that represent components of a comprehensive service, such as separate charges for incision, repair, and closure when these steps are typically included in one primary procedure code. Watch for code patterns where related procedures share the same first three digits, as these often indicate services that should be bundled together under Medicare's Correct Coding Initiative. Check for appropriate modifier usage, particularly modifier 59 or XS, which legitimately allow separate billing when procedures are performed on different anatomical sites or during distinct sessions. Without proper modifiers, separately billed related procedures may represent charges above the benchmark. Compare your itemized statement against standard bundling practices for your specific procedure type to identify potential differences in billing patterns.
All bundling rules for 0431U
366 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0029U | Rx metab advrs trgt seq alys | May bill with modifier |
| 0070U | Cyp2d6 gen com&slct rar vrnt | May bill with modifier |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 80503 | Path clin consltj sf 5-20 | May bill with modifier |
| 80504 | Path clin consltj mod 21-40 | May bill with modifier |
| 80505 | Path clin consltj high 41-60 | May bill with modifier |
| 81105 | Hpa-1 genotyping | May bill with modifier |
| 81106 | Hpa-2 genotyping | May bill with modifier |
| 81107 | Hpa-3 genotyping | May bill with modifier |
| 81108 | Hpa-4 genotyping | May bill with modifier |
| 81109 | Hpa-5 genotyping | May bill with modifier |
| 81110 | Hpa-6 genotyping | May bill with modifier |
| 81111 | Hpa-9 genotyping | May bill with modifier |
| 81112 | Hpa-15 genotyping | May bill with modifier |
| 81120 | Idh1 common variants | May bill with modifier |
| 81121 | Idh2 common variants | May bill with modifier |
| 81161 | Dmd dup/delet analysis | May bill with modifier |
| 81163 | Brca1&2 gene full seq alys | May bill with modifier |
| 81164 | Brca1&2 gen ful dup/del alys | May bill with modifier |
| 81165 | Brca1 gene full seq alys | May bill with modifier |
| 81166 | Brca1 gene full dup/del alys | May bill with modifier |
| 81167 | Brca2 gene full dup/del alys | May bill with modifier |
| 81168 | Ccnd1/igh translocation alys | May bill with modifier |
| 81170 | Abl1 gene | May bill with modifier |
| 81171 | Aff2 gen aly detc abnl allel | May bill with modifier |
| 81172 | Aff2 gen alys charac alleles | May bill with modifier |
| 81173 | Ar gene full gene sequence | May bill with modifier |
| 81174 | Ar gene known famil variant | May bill with modifier |
| 81175 | Asxl1 full gene sequence | May bill with modifier |
| 81176 | Asxl1 gene target seq alys | May bill with modifier |
| 81177 | Atn1 gene detc abnor alleles | May bill with modifier |
| 81178 | Atxn1 gene detc abnor allele | May bill with modifier |
| 81179 | Atxn2 gene detc abnor allele | May bill with modifier |
| 81180 | Atxn3 gene detc abnor allele | May bill with modifier |
| 81181 | Atxn7 gene detc abnor allele | May bill with modifier |
| 81182 | Atxn8os gen detc abnor allel | May bill with modifier |
| 81183 | Atxn10 gene detc abnor allel | May bill with modifier |
| 81184 | Cacna1a gen detc abnor allel | May bill with modifier |
| 81185 | Cacna1a gene full gene seq | May bill with modifier |
| 81186 | Cacna1a gen known famil vrnt | May bill with modifier |
| 81187 | Cnbp gene detc abnor allele | May bill with modifier |
| 81188 | Cstb gene detc abnor allele | May bill with modifier |
| 81189 | Cstb gene full gene sequence | May bill with modifier |
| 81190 | Cstb gene known famil vrnt | May bill with modifier |
| 81191 | Ntrk1 translocation analysis | May bill with modifier |
| 81192 | Ntrk2 translocation analysis | May bill with modifier |
| 81193 | Ntrk3 translocation analysis | May bill with modifier |
| 81194 | Ntrk translocation analysis | May bill with modifier |
| 81200 | Aspa gene | May bill with modifier |
Showing 50 of 366 rules. Show all
FAQ — medical procedure bundling
What is NCCI bundling and what does 'bundled' mean on a medical bill?
How can I identify if codes were incorrectly unbundled on my bill?
What should I do if I find unbundled charges on my medical bill?
When is it legitimate to use modifiers to override NCCI bundling rules?
Data source: CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits, updated quarterly. These code pairs are maintained by CMS to prevent improper billing of services that should be billed as a single procedure.
What this means: When two codes are listed as an NCCI edit pair, billing them separately on the same date of service is typically incorrect. "Never bill together" means no modifier can override the rule. "May bill with modifier" means the codes can be billed separately with appropriate documentation.