CARC · PI group
PI-97
Bundled into another service, payer-initiated
Payer initiated reduction
- What it means
- The payer bundled the line without making it a contractual write-off or patient balance.
- Likely cause
- Payer-specific bundling edits beyond standard NCCI pairs.
- How to fix it
- Compare against NCCI and your contract; appeal where the bundling is not contractually supported.
- Revenue impact
- Frequently recoverable and almost never worked.
- bundling
- payer initiated
- appeal
Related codes
Early access
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