Arthrd ant ntrbd min dsc ea — 55 bundling rules
If your bill lists 22585 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 22585
55 code pairs that have billing restrictions with this procedure.
| Code | Description | Rule |
|---|---|---|
| 0333T | Visual ep scr acuity auto | Never bill together |
| 0464T | Visual ep test for glaucoma | Never bill together |
| 11000 | Dbrdmt ecz/infected skin<10% | May bill with modifier |
| 11001 | Dbrdmt ecz/infct skn ea addl | May bill with modifier |
| 11004 | Dbrdmt skin xtrnl gent&per | May bill with modifier |
| 11005 | Dbrdmt skin abdominal wall | May bill with modifier |
| 11006 | Dbrdmt skin xtrnl gent per | May bill with modifier |
| 11042 | Dbrdmt subq tis 1st 20sqcm/< | May bill with modifier |
| 11043 | Dbrdmt musc&/fsca 1st 20/< | May bill with modifier |
| 11044 | Dbrdmt bone 1st 20 sq cm/< | May bill with modifier |
| 11045 | Dbrdmt subq tiss each addl | May bill with modifier |
| 11046 | Dbrdmt musc&/fsca ea addl | May bill with modifier |
| 11047 | Dbrdmt bone each addl | May bill with modifier |
| 20660 | Apply rem fixation device | Never bill together |
| 36591 | Draw blood off venous device | Never bill together |
| 36592 | Collect blood from picc | Never bill together |
| 38220 | Dx bone marrow aspirations | Never bill together |
| 38222 | Dx bone marrow bx & aspir | Never bill together |
| 38230 | Bone marrow harvest allogen | Never bill together |
| 38232 | Bone marrow harvest autolog | Never bill together |
| 63707 | Repair spinal fluid leakage | May bill with modifier |
| 63709 | Repair spinal fluid leakage | May bill with modifier |
| 92652 | Aep thrshld est mlt freq i&r | Never bill together |
| 92653 | Aep neurodiagnostic i&r | Never bill together |
| 95822 | Eeg coma or sleep only | Never bill together |
| 95860 | Needle emg 1 extremity | Never bill together |
| 95861 | Needle emg 2 extremities | Never bill together |
| 95863 | Needle emg 3 extremities | Never bill together |
| 95864 | Needle emg 4 extremities | Never bill together |
| 95865 | Needle emg larynx | Never bill together |
| 95866 | Needle emg hemidiaphragm | Never bill together |
| 95867 | Ndl emg cranial nrv musc uni | Never bill together |
| 95868 | Ndl emg cranial nrv musc bi | Never bill together |
| 95869 | Ndl emg thrc paraspinal musc | Never bill together |
| 95907 | Nvr cndj tst 1-2 studies | Never bill together |
| 95908 | Nrv cndj tst 3-4 studies | Never bill together |
| 95909 | Nrv cndj tst 5-6 studies | Never bill together |
| 95910 | Nrv cndj test 7-8 studies | Never bill together |
| 95911 | Nrv cndj test 9-10 studies | Never bill together |
| 95912 | Nrv cndj test 11-12 studies | Never bill together |
| 95913 | Nrv cndj test 13/> studies | Never bill together |
| 95925 | Somatosensory testing | Never bill together |
| 95926 | Somatosensory testing | Never bill together |
| 95927 | Somatosensory testing | Never bill together |
| 95930 | Visual ep test cns w/i&r | Never bill together |
| 95933 | Blink reflex test | Never bill together |
| 95937 | Neuromuscular junction test | Never bill together |
| 95938 | Somatosensory testing | Never bill together |
| 95939 | C motor evoked upr&lwr limbs | Never bill together |
| 95940 | Ionm in operatng room 15 min | Never bill together |
Showing 50 of 55 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.