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Bundling procedures

  1. #1
    Question Bundling procedures
    Medical Coding Books
    I have a question regarding bundling procedures. We have some procedures that are getting paid by Private payers that are being bundled by say Medicare. Is this correct to submit and get paid for these claims that are being billed out to the private payers. Or should we follow the Medicare guidelines. Any websites or anything would be helpful.


  2. #2
    North Carolina
    While it is true that not all carriers follow Medicare's edits, most major carriers do. Most of my carriers have a statment on their website (example- UHC, BCBS...) that they do enforce Medicare's NCCI edits and even some of Medicare's LMRP. I would check with your individual carriers for this information.

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