Escolar Documentos
Profissional Documentos
Cultura Documentos
By Susan Dooley
Bundling of payments this is a trend you can expect to see continue to grow, with effects on a wider
array of services. Many physicians have experience with bundling in the form of global surgery periods
or global payments for obstetrical care. In a newer wrinkle of bundling, called a bundled payment
methodology, a single bundled payment covers services delivered by two or more providers during an
episode of care or over a specified period of time. For example, say a patient has coronary artery bypass
grafting (CABG) surgery. The payer would make a single combined payment for that episode of CABG,
rather than making one payment to the hospital, another to the surgeon, and a third to the
anesthesiologist. This bundled payment might be paid to a single entity, such as an accountable care
organization (ACO), which would then piece out the payments to the participating providers. In the
absence of an ACO, virtual bundling may be used instead, where the payer pays the providers
individually but according to prenegotiated, defined rules, so that all the provider payments together do
not exceed the previously agreed upon bundled payment amount.
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com
The above three codes are now column 2 codes to pretty much all of the 56xxx to 59xxx female genital
system codes. As you recall, with CCI edit pairs, the Column 1 code represents the more significant
procedure or service when reported with the Column 2 code. Column 1 codes usually have a higher
work relative value unit (RVU) than do the column 2 codes. In the case of the PVB codes (64461 and
64463), the bundles have a 0 modifier indicator, which means you cant append a modifier to those
codes to unbundle them.
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com
The Coding Institute LLC, 2222 Sedwick Road, Durham, NC 27713, Eenterprise Contact: Sam Nair, Direct: 704 303 8150,
shyamn@codinginstitute.com