What is considered unbundling in laboratory services?

Unbundling in laboratory services refers to the practice of billing for individual components of a panel of tests when these tests are already included as part of a comprehensive panel price. Many laboratory tests are grouped together into panels that are designed to assess a particular condition or multiple related conditions. When a healthcare provider separates the individual tests within that panel and bills for each one separately, this is considered unbundling.

This practice can lead to inflated charges and may violate appropriate billing guidelines, making it essential for coders and healthcare providers to adhere to the standard coding practices that dictate billing for panel tests as a whole rather than itemizing them individually. Proper understanding of these billing guidelines ensures compliance with billing regulations and helps prevent potential audits or denials from insurance carriers.