Dbrdmt bone each addl — 56 bundling rules
If your bill lists 11047 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 — Surgery procedures
Unbundling occurs when hospitals bill component steps of a surgical procedure separately instead of using the appropriate comprehensive code that covers the entire operation. The NCCI database contains 1,142 surgery codes with bundling restrictions to prevent this practice. Common unbundling patterns include separately billing for surgical approach and closure when these are integral components of the main procedure, and charging for routine preparation steps like positioning or draping that are already included in the primary surgical code. Another frequent error involves billing separately for minor procedures performed during the same operative session that should be considered incidental to the major surgery. These billing practices result in charges above the benchmark for what should constitute a single surgical service. Patients may face potential differences in their financial responsibility when component procedures are unbundled rather than appropriately consolidated under comprehensive surgical codes. Understanding these bundling rules helps ensure accurate billing that reflects the actual scope of surgical services provided during a single operative encounter.
What to check on your bill
When reviewing surgery bills, patients should examine itemized charges for potential unbundling issues. Look for multiple procedure codes billed separately when they should be bundled together under standard billing practices. Watch for code patterns where a primary procedure appears alongside related minor procedures without appropriate modifiers - for example, seeing separate charges for incision, repair, and closure that typically comprise one surgical package. Check that modifier codes like -59 or -25 are present when separate procedures are legitimately billed, as these indicate the charges meet specific criteria for separate billing. Verify that pre-operative and post-operative care aren't billed separately from the main procedure unless clearly documented as distinct services. Compare your itemized statement against the original procedure authorization to identify any charges above the benchmark for your specific surgery type, noting potential differences between bundled and unbundled billing approaches.
All bundling rules for 11047
56 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0925T | Rlcj skin pocket ccm-d pg | Never bill together |
| 20560 | Ndl insj w/o njx 1 or 2 musc | May bill with modifier |
| 20561 | Ndl insj w/o njx 3+ musc | May bill with modifier |
| 29000 | Application of body cast | May bill with modifier |
| 29010 | Application of body cast | May bill with modifier |
| 29015 | Application of body cast | May bill with modifier |
| 29035 | Application of body cast | May bill with modifier |
| 29040 | Application of body cast | May bill with modifier |
| 29044 | Application of body cast | May bill with modifier |
| 29046 | Application of body cast | May bill with modifier |
| 29049 | Application of figure eight | May bill with modifier |
| 29055 | Application of shoulder cast | May bill with modifier |
| 29058 | Application of shoulder cast | May bill with modifier |
| 29065 | Application of long arm cast | May bill with modifier |
| 29075 | Application of forearm cast | May bill with modifier |
| 29085 | Apply hand/wrist cast | May bill with modifier |
| 29086 | Apply finger cast | May bill with modifier |
| 29105 | Apply long arm splint | May bill with modifier |
| 29125 | Apply forearm splint | May bill with modifier |
| 29126 | Apply forearm splint | May bill with modifier |
| 29130 | Application of finger splint | May bill with modifier |
| 29131 | Application of finger splint | May bill with modifier |
| 29200 | Strapping thorax | May bill with modifier |
| 29240 | Strapping of shoulder | May bill with modifier |
| 29260 | Strapping of elbow or wrist | May bill with modifier |
| 29280 | Strapping of hand or finger | May bill with modifier |
| 29305 | Application of hip cast | May bill with modifier |
| 29325 | Application of hip casts | May bill with modifier |
| 29345 | Application of long leg cast | May bill with modifier |
| 29355 | Application of long leg cast | May bill with modifier |
| 29358 | Apply long leg cast brace | May bill with modifier |
| 29365 | Application of long leg cast | May bill with modifier |
| 29405 | Apply short leg cast | May bill with modifier |
| 29425 | Apply short leg cast | May bill with modifier |
| 29435 | Apply short leg cast | May bill with modifier |
| 29440 | Addition of walker to cast | May bill with modifier |
| 29445 | Apply rigid leg cast | May bill with modifier |
| 29450 | Application of leg cast | May bill with modifier |
| 29505 | Application long leg splint | May bill with modifier |
| 29515 | Application lower leg splint | May bill with modifier |
| 29520 | Strapping of hip | May bill with modifier |
| 29530 | Strapping of knee | May bill with modifier |
| 29540 | Strapping of ankle and/or ft | May bill with modifier |
| 29550 | Strapping of toes | May bill with modifier |
| 29580 | Strapping unna boot | May bill with modifier |
| 29581 | Apply multlay comprs lwr leg | May bill with modifier |
| 29584 | Appl multlay comprs arm/hand | May bill with modifier |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 66987 | Xcapsl ctrc rmvl cplx w/ecp | May bill with modifier |
Showing 50 of 56 rules. Show all
FAQ — Surgery procedure bundling
What is NCCI bundling and what does 'bundled' mean on a medical bill?
How can I determine if surgical codes were incorrectly unbundled on my bill?
What should I do if I find unbundled charges on my medical bill?
When is it legitimate for hospitals to use modifiers to bypass 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.