What is the practice of submitting more CPT codes than necessary to describe a service?

The practice of submitting more CPT codes than necessary to describe a service is known as unbundling. Unbundling occurs when providers separate a service into its individual components and bill for each one separately, rather than using a bundled code that encompasses all components of the service. This can lead to increased healthcare costs and is often scrutinized by payers since it may result in higher reimbursements than what might be appropriate for the service rendered.

Unbundling is distinct from concepts like overcoding, which involves misrepresenting the complexity or scope of a service, and it ultimately can have implications for compliance and revenue integrity within the revenue cycle. Understanding this concept is crucial for professionals in RCM to ensure ethical and compliant billing practices are followed, which aligns with the principles of accurate coding and billing in healthcare.