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Double-Charge Detector 0461U

Onc rxgenom alys rtpcr 24gen — 29 bundling rules

If your bill lists 0461U alongside any of these codes as separate charges, it may be an unbundling error.

By David Park , Healthcare Cost Researcher · ·
About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

NCCI edit data
29 code pairs
Updated 2026-04-03
Bundling rules — 0461U
NCCI edits: these codes have billing restrictions when billed with 0461U
0461U0009UOnc brst ca erbb2 amp/nonampMay bill with modifier0021UOnc prst8 detcj 8 autoantbMay bill with modifier0091U0091UMay bill with modifier0111UOnc colon ca kras&nras alysMay bill with modifier0155UOnc brst ca dna pik3ca geneMay bill with modifier0177UOnc brst ca dna pik3ca 11May bill with modifier0229UBcat1&ikzf1 prmtr mthyln alyMay bill with modifier0286UCep72 nudt15&tpmt gene alysMay bill with modifier
Research suggests 49–80% of hospital bills contain errors. Our system checks every line item against Medicare benchmarks.

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 0461U

29 code pairs that have billing restrictions with this procedure.

0
Never bill together
29
May bill with modifier
Code Description Rule
0009U Onc brst ca erbb2 amp/nonamp May bill with modifier
0021U Onc prst8 detcj 8 autoantb May bill with modifier
0091U 0091U May bill with modifier
0111U Onc colon ca kras&nras alys May bill with modifier
0155U Onc brst ca dna pik3ca gene May bill with modifier
0177U Onc brst ca dna pik3ca 11 May bill with modifier
0229U Bcat1&ikzf1 prmtr mthyln aly May bill with modifier
0286U Cep72 nudt15&tpmt gene alys May bill with modifier
0343U Onc prst8 xom aly 442 sncrna May bill with modifier
0359U Onc prst8 ca alys all psa May bill with modifier
0368U Onc clrct ca mut&mthyltn mrk May bill with modifier
0403U Onc prst8 mrna 18 gen 1st ur May bill with modifier
0406U Onc lung flow cytmtry 5 mrk May bill with modifier
0421U Onc clrct scr sgl amp 8 rna May bill with modifier
0424U Onc prst8 xom alys 53 sncrna May bill with modifier
0433U Onc prst8 5 dna reg mrk pcr May bill with modifier
0453U Onc clrct ca cfdna qpcr asy May bill with modifier
0470U Onc orop detcj mrd 8 dna hpv May bill with modifier
0471U Onc clrc ca 35 vrn kras&nras May bill with modifier
0501U Onc clrc bld quan meas cfdna May bill with modifier
81328 Slco1b1 gene com variants May bill with modifier
81400 Mopath procedure level 1 May bill with modifier
81401 Mopath procedure level 2 May bill with modifier
81402 Mopath procedure level 3 May bill with modifier
81403 Mopath procedure level 4 May bill with modifier
81404 Mopath procedure level 5 May bill with modifier
81405 Mopath procedure level 6 May bill with modifier
81406 Mopath procedure level 7 May bill with modifier
81407 Mopath procedure level 8 May bill with modifier

FAQ — medical procedure bundling

What is NCCI bundling and what does 'bundled' mean on a medical bill?
NCCI bundling refers to the National Correct Coding Initiative rules that prevent certain procedure codes from being billed separately when performed together. When codes are bundled, one procedure is considered inclusive of another, meaning only the primary procedure should be billed rather than charging for each component separately.
How can I identify if codes were incorrectly unbundled on my bill?
Incorrectly unbundled codes appear as separate line items on your bill when NCCI rules indicate they should be grouped together under one primary procedure code. This typically occurs with anesthesia, radiology, pathology, and miscellaneous support services that are considered integral to the main procedure being performed.
What should I do if I find unbundled charges on my medical bill?
Contact your healthcare provider's billing department to request a review of the charges and provide documentation showing the NCCI bundling rules that apply. Request an itemized explanation of why the codes were billed separately and ask for a corrected bill that reflects proper bundling if no valid modifier justification exists.
When is it legitimate to use modifiers to override NCCI bundling rules?
Modifiers are appropriately used when procedures are performed on different anatomical sites, during separate patient encounters, or when distinct procedural services are provided that don't fall under the bundling restrictions. The modifier usage must be supported by clear documentation in the medical record that demonstrates the services were truly separate and distinct from the bundled procedure.
Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

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.

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