unbundling

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The practice of expanding into individual units a group of diagnostic or procedural test codes—based on the 4th edition of Current Procedural Terminology (CPT) coding promulgated by the American Medical Association—that might have been previously included as a ‘panel’, to maximise reimbursement from third party payers

unbundling

Exploding Medicare reimbursement A fraudulent practice in which provider services–eg, blood or chemistry panels are broken down to their individual components, resulting in a higher payment by Medicare. See Fraud, HIPA Act, Rebundling, Upcoding.

un·bund·ling

(ŭn-bŭnd'ling)
Use of several Current Procedural Terminology codes for a service when one inclusive code is available.

unbundling

Separately billing for laboratory tests or procedures that are normally linked in order to extract more money from a payer (such as Medicare). This practice is illegal in the U.S.
References in periodicals archive ?
Up to this point, ILECs have been playing a game of brinksmanship with business customers by threatening to replace all high capacity unbundled network elements, with significantly higher priced tariff services, without engaging in the negotiations called for by the FCC.
Jal Mehta of Harvard University and Northwestern University's Jim Spillane take a more skeptical look at unbundling, exploring questions of public oversight, professional development, and accountability in an unbundled world.
The New Hampshire Supreme Court recently approved similar rule changes, allowing unbundled services in all civil cases.
Unbundled lines accounted for an average 18% of DSL connections at the end of 2005, compared to 8% at the end of 2003.
The deal, following a successful trial which began in November 2005, guarantees a minimum of 20,000 unbundled lines.
Bar Unlicensed Practice of Law Counsel Lori Holcomb reported to the Bar Board of Governors last month on a special committee that has been reviewing the unbundled rules, which became effective January 1, 2004.
It's very difficult when you're relying on an unbundled system, in terms of budgeting and staffing predictions, and food preparation.
Unbundled legal services is a practice in which the lawyer and client agree that the lawyer will provide some, but not all, of the work involved in traditional full service representation.
As that question is answered, one market at a time, two key distinctions for insurers will be whether the privatized systems favor group or individual products, and whether group markets develop according to bundled or unbundled models.
Most of the larger providers appear to be targeting both ends of the business: the bundled, all-inclusive retirement plan management and the unbundled option, offering services such as recordkeeping and investment management separately.
In the past year, 5-10 percent of reviewed anesthesia claims have been unbundled (e.
Unbundled Bitstream Access and UBA Enhanced services are now available from Telecom following previous regulatory reforms.