Duplex scan hemo fstl lmtd — 95 bundling rules
If your bill lists 0876T 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 — 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 0876T
95 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0689T | Quan us tis charac w/o dx us | May bill with modifier |
| 0871T | Rplcmt subq prtl ascites pmp | Never bill together |
| 0872T | Rplcmt ndwllg bldr&prtl cath | Never bill together |
| 0873T | Revj subq prtl asct pmp sys | Never bill together |
| 0874T | Rmvl pertl ascites pmp sys | Never bill together |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 36600 | Withdrawal of arterial blood | May bill with modifier |
| 51703 | Insert bladder cath complex | May bill with modifier |
| 62324 | Njx interlaminar crv/thrc | Never bill together |
| 64405 | Njx aa&/strd gr ocpl nrv | Never bill together |
| 64416 | Njx aa&/strd brch pl nfs img | Never bill together |
| 76998 | Us guide intraop | May bill with modifier |
| 90956 | Esrd srv 1 visit p mo 2-11 | Never bill together |
| 90959 | Esrd serv 1 vst p mo 12-19 | Never bill together |
| 90960 | Esrd srv 4 visits p mo 20+ | Never bill together |
| 90963 | Esrd home pt serv p mo <2yrs | Never bill together |
| 90966 | Esrd home pt serv p mo 20+ | Never bill together |
| 93000 | Electrocardiogram complete | May bill with modifier |
| 93005 | Electrocardiogram tracing | May bill with modifier |
| 93010 | Electrocardiogram report | May bill with modifier |
| 93040 | Rhythm ecg with report | May bill with modifier |
| 93041 | Rhythm ecg tracing | May bill with modifier |
| 93042 | Rhythm ecg report | May bill with modifier |
| 93925 | Lower extremity study | May bill with modifier |
| 93926 | Lower extremity study | May bill with modifier |
| 93930 | Upper extremity study | May bill with modifier |
| 93931 | Upper extremity study | May bill with modifier |
| 93970 | Extremity study | May bill with modifier |
| 93971 | Extremity study | May bill with modifier |
| 93986 | Dup-scan hemo compl uni std | May bill with modifier |
| 93990 | Doppler flow testing | Never bill together |
| 96360 | Hydration iv infusion init | May bill with modifier |
| 96365 | Ther/proph/diag iv inf init | Never bill together |
| 96372 | Ther/proph/diag inj sc/im | May bill with modifier |
| 96374 | Ther/proph/diag inj iv push | May bill with modifier |
| 96523 | Irrig drug delivery device | Never bill together |
| 97597 | Dbrdmt opn wnd 1st 20 cm/< | May bill with modifier |
| 97602 | Wound(s) care non-selective | May bill with modifier |
| 99155 | Mod sed oth phys/qhp <5 yrs | Never bill together |
| 99156 | Mod sed oth phys/qhp 5/>yrs | Never bill together |
| 99211 | Off/op est may x req phy/qhp | May bill with modifier |
| 99212 | Office o/p est sf 10 min | May bill with modifier |
| 99213 | Office o/p est low 20 min | May bill with modifier |
| 99214 | Office o/p est mod 30 min | May bill with modifier |
| 99215 | Office o/p est hi 40 min | May bill with modifier |
| 99221 | 1st hosp ip/obs sf/low 40 | May bill with modifier |
| 99222 | 1st hosp ip/obs moderate 55 | May bill with modifier |
| 99223 | 1st hosp ip/obs high 75 | May bill with modifier |
| 99231 | Sbsq hosp ip/obs sf/low 25 | May bill with modifier |
Showing 50 of 95 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.