Commercial Code Bundling

Overview

Note: For Professional Claims Only

BlueCross BlueShield of Tennessee applies code bundling rules to evaluate the accuracy and adherence of medical claims to accepted national standards. These rules are based on code bundling guidelines such as:

National Correct Coding Initiative (NCCI)
American Medical Association
Centers for Medicare and Medicaid Services
American Academy of Orthopaedic Surgeons (AAOS)
American College of Obstetricians and Gynecologists (ACOG)
BlueCross BlueShield of Tennessee clinical expertise

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Definitions

Comprehensive Code (Column 1) Generally represents the major procedure or service when reported with another code.

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Code Changes

Below, please find effective code changes:

CPT

Remittance Explanation

Surgical Procedure

Bundling Rationale

BlueCross BlueShield of Tennessee uses a clinical editing database. The clinical editing rationale supporting this database is provided here to assist you in understanding the rationale behind certain code pairs in the database.

Code Bundling Rationale 2014 Q2

CPT® Codes

Code Bundling Rationale 2014 Q1

CPT® Codes

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Summary of Changes

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