Bundling of CPT Codes to Continue

Bundling of CPT Codes to Continue All of medicine continues to feel the effects of the Centers for Medicare and Medicaid Services' (CMS) initiative to bundle codes (ie, combine multiple codes into a single code) and, thereby, reduce Medicare payments for those procedures performed together greater than 75% of the time. For radiology, this was realized in 2010 with the creation of: combined myocardial perfusion imaging, wall motion, and ejection fraction study codes ( 78451 - 78454 ); combined arteriovenous shunt dialysis catheter procedures and radiological supervision and interpretation (RS&I) codes ( 36147 , 36148 ); and facet joint...

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Note:  The following article synopsis was NOT provided by the AMA. It was created by Find-A-Code/innoviHealth.

Article Overview

This article discusses ongoing CMS efforts to bundle frequently performed together services, with emphasis on radiology and related procedures. It is useful for hospital coders, radiology billing teams, charge master staff, and payment policy readers who need to understand the broad scope of bundling activity, the kinds of code groups affected, and how CMS uses utilization-based screening and valuation review in future updates.

Why This Topic Matters

Bundling can change how related services are reported and priced, which affects hospital charge masters, outpatient payment analysis, and reimbursement planning. The article also places these changes in the broader context of CMS review processes and future code revaluation activity.

Article Sections

  1. CMS bundling initiative and radiology examples

    Introduces the CMS bundling initiative and summarizes radiology-related services that were affected in earlier years.

  2. 2011 bundling developments

    Reviews additional service groups identified for bundling during the following year and notes the types of procedures involved.

  3. 2012 bundled code pairs and related services

    Outlines more procedure groups added to the bundling screen and the clinical areas they affect.

  4. Future bundling and CMS review activity

    Describes additional services being considered for later revision and broader CMS screening for potentially misvalued services.

  5. Operational impact for hospitals and payment systems

    Discusses the need to align charge masters and cost reporting with bundled payment structures and to support pricing for outpatient payment categories.

What You Will Learn

  • How CMS bundling trends are affecting radiology-related services
  • What kinds of procedure groupings have been targeted in successive years
  • Why hospitals need to review charge masters and cost reporting
  • How CMS screening relates to future payment revaluation activity
  • Which general service areas are being considered for further review

Who Should Read This

  • Hospital coders
  • Radiology billing staff
  • Charge master analysts
  • Revenue cycle professionals
  • Payment policy analysts

Codes Discussed

Code Ranges Discussed


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