What does the term "unbundling" refer to in medical coding?

The term "unbundling" in medical coding refers to the practice of submitting multiple CPT (Current Procedural Terminology) codes instead of one comprehensive code that describes a particular procedure or service. This practice can lead to increased billing, as each separate code may result in a higher total reimbursement than the bundled payment for the entire service. Unbundling is often viewed as unethical and can lead to legal repercussions or audits, as it can misrepresent the services provided and inflate costs for insurance providers or patients.

This understanding of unbundling is crucial for medical assistants and billing professionals, as adhering to correct coding practices is fundamental for maintaining compliance with healthcare regulations and ensuring appropriate reimbursement for services rendered. Proper understanding of coding nuances helps in minimizing financial and legal risks associated with billing practices.