Wiki CPT CODE 93458 possible unbundling

[fuzzyrabbit]

patient had a cardiac cath and the CPT code provided by the facility is 93458. I have a stmt with a charge for this code along with separate charges for supplies. Is the facility unbundling these charges? thank you

 

[thomas7331]

patient had a cardiac cath and the CPT code provided by the facility is 93458. I have a stmt with a charge for this code along with separate charges for supplies. Is the facility unbundling these charges? thank you

No it's not - facilities itemize their expenses on the UB-04 claims, including all supplies and drugs that are used during the encounter, unless otherwise specified in their contracts. It is not unbundling unless they are reporting a code for which the service has already been reported as a component of another code (e.g. an individual lab test which is also included in a lab panel billed on that same claim), in which case there is usually an edit in place that requires a modifier to bypass.