What is incorrect bundling?
Incorrect bundling is when a payer treats a separately payable service as included in another service and pays nothing for it.
Some services are legitimately included in others under coding rules. Incorrect bundling happens when the payer applies those edits to services that should have been paid separately, for example because a modifier was billed or the services were distinct.
On the remittance it typically appears with claim adjustment reason code 97: the benefit for this service is included in the payment for another service.
How to spot it
- Review lines adjusted with CARC 97 where a modifier such as 59 or 25 was billed.
How Vareo helps
Vareo checks every line of your 835 remittances against your payer contracts, finds underpayments like this, and handles the appeals and follow-up. You pay only a share of what is recovered.
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Last updated October 11, 2026