Tcat mv annulus rcnstj — 135 bundling rules
If your bill lists 0544T alongside any of these codes as separate charges, it may be an unbundling error.
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
Common unbundling errors — Other 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 0544T
135 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 01920 | Anesth catheterize heart | Never bill together |
| 01924 | Anes ther interven rad artrl | Never bill together |
| 01926 | Anes tx interv rad hrt/cran | Never bill together |
| 0213T | Njx paravert w/us cer/thor | Never bill together |
| 0216T | Njx paravert w/us lumb/sac | Never bill together |
| 0345T | Transcath mtral vlve repair | Never bill together |
| 0483T | Tmvi percutaneous approach | Never bill together |
| 0484T | Tmvi transthoracic exposure | Never bill together |
| 0632T | Perq tcat us abltj nrv p-art | Never bill together |
| 0643T | Tcat l ventr rstrj dev implt | Never bill together |
| 12042 | Intmd rpr n-hf/genit2.6-7.5 | May bill with modifier |
| 12044 | Intmd rpr n-hf/genit7.6-12.5 | May bill with modifier |
| 12045 | Intmd rpr n-hf/genit12.6-20 | May bill with modifier |
| 12046 | Intmd rpr n-hf/genit20.1-30 | May bill with modifier |
| 12047 | Intmd rpr n-hf/genit >30.0cm | May bill with modifier |
| 13131 | Cmplx rpr f/c/c/m/n/ax/g/h/f | May bill with modifier |
| 13132 | Cmplx rpr f/c/c/m/n/ax/g/h/f | May bill with modifier |
| 13133 | Cmplx rpr f/c/c/m/n/ax/g/h/f | May bill with modifier |
| 32554 | Aspirate pleura w/o imaging | May bill with modifier |
| 32555 | Aspirate pleura w/ imaging | May bill with modifier |
| 32556 | Insert cath pleura w/o image | May bill with modifier |
| 32557 | Insert cath pleura w/ image | May bill with modifier |
| 33210 | Insert electrd/pm cath sngl | Never bill together |
| 33211 | Insert card electrodes dual | Never bill together |
| 33254 | Ablate atria lmtd | Never bill together |
| 33255 | Ablate atria w/o bypass ext | Never bill together |
| 33256 | Ablate atria w/bypass exten | Never bill together |
| 33310 | Exploratory heart surgery | May bill with modifier |
| 33315 | Exploratory heart surgery | May bill with modifier |
| 33418 | Repair tcat mitral valve | Never bill together |
| 33419 | Repair tcat mitral valve | Never bill together |
| 35207 | Rpr bld vsl dir hand finger | May bill with modifier |
| 35221 | Rpr bld vsl dir intra-abdl | May bill with modifier |
| 35236 | Repair blvsl vn grf uxtr | May bill with modifier |
| 35241 | Rpr blvsl vn grf ntrthrc w/b | May bill with modifier |
| 35246 | Rpr blvsl vn grf ntrthrc w/o | May bill with modifier |
| 35251 | Rpr blvsl vn grf intra-abdl | May bill with modifier |
| 35256 | Repair blvsl vn grf lxtr | May bill with modifier |
| 35281 | Rpr blvsl gr ot/th vn ntr-ab | May bill with modifier |
| 35286 | Rpr blvsl grf oth/th vn lxtr | May bill with modifier |
| 36010 | Place catheter in vein | May bill with modifier |
| 36013 | Place catheter in artery | Never bill together |
| 36014 | Place catheter in artery | Never bill together |
| 36015 | Place catheter in artery | Never bill together |
| 36100 | Establish access to artery | May bill with modifier |
| 36140 | Intro ndl icath upr/lxtr art | May bill with modifier |
| 36160 | Establish access to aorta | May bill with modifier |
| 36200 | Place catheter in aorta | May bill with modifier |
| 36500 | Insertion of catheter vein | May bill with modifier |
| 36555 | Insert non-tunnel cv cath | May bill with modifier |
Showing 50 of 135 rules. Show all
FAQ — Other 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.