Which term describes the billing practice that results in higher charges by billing for separate items that were part of a single procedure?

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

Answer: (D)

Unbundling describes billing separately for components that are normally included in a single procedure, which inflates charges. When a payer assigns a bundled code that covers the entire operation, charging for its parts—such as supplies, implants, or steps that should be encompassed by that bundle—results in higher reimbursement than proper coding. This differs from upcoding, which involves using a higher-cost code for the service actually performed, and from durable medical equipment, which is unrelated to billing a procedure’s components. Fraud is a broader category of deceptive practices, but the term that exactly fits billing separate items that should be part of one procedure is unbundling.