American Health Information Management Association (AHIMA) Certification Practice Exam

When individual tests from an existing panel code are billed separately, this practice is known as what?

1. Optimizing

2. Unbundling

3. Sequencing

4. Classifying

The correct answer is: Unbundling

The practice of billing individual tests separately from a panel code is referred to as unbundling. This means that instead of billing for the panel as a single entity, each component of the panel is itemized and billed individually. Unbundling is important to understand because it can have significant implications for reimbursement and coding compliance; it may lead to higher overall charges but can also result in audits if not justified adequately. In contrast, optimizing generally refers to the process of improving efficiency or effectiveness, particularly in billing practices or coding, rather than the specific act of separating codes. Sequencing involves the order in which codes or tests are billed, and classifying relates to organizing or categorizing information rather than the billing process itself. Each of these terms addresses different aspects of healthcare billing and coding, with unbundling specifically denoting the separation of tests from a panel for billing purposes.