Which billing practice involves separating out services or procedures and billing for them individually when they were collectively performed or obtained by a single piece of equipment or as components of a single procedure?

• A. Unbundling
• B. Upcoding
• C. Fraud
• D. HIPPA

Answer: (A)

Unbundling is the practice of separating components of a single procedure or service into individual billable items instead of using the bundled code that should cover the entire service. Payers expect certain services to be billed as a package; breaking them into separate charges when they were performed together or with one piece of equipment inflates payment and violates billing rules.

For example, a procedure that includes multiple steps or devices that are normally billed together would be improperly unbundled if each step or component is coded separately. This differs from upcoding, which is charging for a higher-level service than was provided, and from fraud in general, which covers a broader range of deceptive practices. HIPAA relates to patient privacy and information security, not billing consolidation.