The insurace carrier is stating that some of charges are bundled

mlwinet

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I am in the process of doing an appeal related to the insurance carrier stating that a couple of the charges are bundled. I looked up NCCI edits and they do show that the charges can be billed separately but the NCCI edits are related to providers and OP charges. I am appealing for In-patient facility charges. Where can I go to see if these charges are bundled or not?
 
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I am in the process of doing an appeal related to the insurance carrier stating that a couple of the charges are bundled. I looked up NCCI edits and they do show that the charges can be billed separately but the NCCI edits are related to providers and OP charges. I am appealing for In-patient facility charges. Where can I go to see if these charges are bundled or not?

What codes are you dealing with? Is this for MC or MD? Can you provide more information?
 

CodingKing

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NCCI edits can be applied to inpatient its just not the common to see as the payment methodologies are not one where you are typically reimbursed based off the actual services provided. Usually its DRG, Per Diem or a Case Rate.
 
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