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.
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References in periodicals archive ?
Once adjusted for unbundling costs, EBIT was down CHF 15 million on the previous year.
But a five-page draft memo by the DOE on unbundling - released by Zarate and Bayan Muna chairman and Makabayan senatorial candidate Neri Colmenares - showed that oil companies were required to hold a press conference to answer public queries.
Then they said that they would issue an unbundling memo,' he said.
Baldwin's unbundling framework has been summarized in Figure 1.
However, actual compliance of the unbundling process will depend on many practical aspects, on corporate and legal solutions shaping the future transmission system operator (TSO) and its interaction with other stakeholders in the sector.
In the United States unbundling resulted in independent power producers (IPPs) entering the market for generation.
The unions had been poised to announce strike action back in January, but decided against it after receiving assurances -- from President Nicos Anastasiades, among others -- that the unbundling was not a fait accompli.
unbundling regime--including the long-distance telecommunications
Taken as a whole, unbundling requires a shift in how audiologists think about price and value.
The proposed amendments will only require Latvijas Gaze to "internally" separate distribution and transportation systems, the minister said, but will not mean the gas system's unbundling.
When AirAsia's application for starting an airline here was cleared, we knew the move will get a push as foreign LCCs are famous for unbundling services and charging extra for everything.
" It ( unbundling of auxiliary services) is not going to happen immediately.