What term describes the practice of charging separately for component codes of a single procedure?

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The practice of charging separately for component codes of a single procedure is known as unbundling. This occurs when a healthcare provider bills for multiple individual components of a single procedure instead of using a single comprehensive code that represents the entire service. Unbundling can lead to higher costs for patients and insurers because it artificially inflates billing by treating each part of a service as if it were a standalone procedure.

Unbundling is important to understand in the context of healthcare fraud because it can be used to exploit the reimbursement system, resulting in financial losses for payers. Correct coding is essential for maintaining integrity in billing practices, thus ensuring that healthcare providers are compensated fairly for the services rendered without resorting to unethical practices like unbundling.

The other terms listed do not accurately capture this specific behavior. Overcoding relates to billing for more expensive services than what were actually provided, segregating does not pertain specifically to billing practices, and subdividing doesn’t have a recognized meaning in this context. Thus, unbundling is the precise term that encapsulates the given scenario.

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