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NCCI Code Pairs — 0109U

Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 0109U.

15 Total Edits 12 as Column 1 3 as Column 2
← View HCPCS 0109U Detail Page

Column 1 Pairs 0109U is the primary code

When 0109U is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 4 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standard preparation/monitoring services for anesthesia 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standard preparation/monitoring services for anesthesia 2022-01-01 2199-12-31
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standard preparation/monitoring services for anesthesia 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standard preparation/monitoring services for anesthesia 2022-01-01 2199-12-31
Medicaid Facility — 4 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
Medicaid Practitioner — 4 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2022-01-01 2199-12-31

Column 2 Pairs 0109U is the bundled code

When 0109U is reported as the Column 2 (component) code, it is bundled into the Column 1 comprehensive code and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 1 pair
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0480U · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2026-04-01 2199-12-31
Medicaid Facility — 1 pair
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0480U · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2026-04-01 2199-12-31
Medicaid Practitioner — 1 pair
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0480U · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2026-04-01 2199-12-31

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