NCCI Code Pairs — 0264T
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 0264T.
95 Total Edits
92 as Column 1
3 as Column 2
← View HCPCS 0264T Detail Page
Column 1 Pairs 0264T is the primary code
When 0264T is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 27 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0901T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2025-07-01 | 2199-12-31 |
| 38228 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38225 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 93985 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 93986 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 0537T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 0540T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 38222 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2018-01-01 | 2199-12-31 |
| 76970 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2020-12-31 |
| 38232 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2014-01-01 | 2199-12-31 |
| 38243 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-01-01 | 2199-12-31 |
| 38221 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38220 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38230 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38240 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38241 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38242 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 76942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 76998 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2012-01-01 | 2199-12-31 |
| 93925 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 93926 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 0265T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38204 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38205 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
Medicaid Facility — 29 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0901T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2025-07-01 | 2199-12-31 |
| 38226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38225 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38228 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 93986 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 93985 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 0540T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 0537T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 38222 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2018-01-01 | 2199-12-31 |
| 76970 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2020-12-31 |
| 36592 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2015-10-01 | 2199-12-31 |
| 36591 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2015-10-01 | 2199-12-31 |
| 38232 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2014-01-01 | 2199-12-31 |
| 38243 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-01-01 | 2199-12-31 |
| 38205 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 0265T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38204 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38220 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38221 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38230 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38240 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38241 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38242 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 76942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 76998 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2012-01-01 | 2199-12-31 |
| 93925 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 93926 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
Medicaid Practitioner — 36 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0901T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2025-07-01 | 2199-12-31 |
| 38228 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38225 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 38227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-04-01 | 2199-12-31 |
| 93986 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 93985 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 96523 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-04-01 | 2199-12-31 |
| 99452 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 99451 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 0537T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 0540T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2024-12-31 |
| 38222 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2018-01-01 | 2199-12-31 |
| 76970 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2020-12-31 |
| 36591 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2015-10-01 | 2199-12-31 |
| 36592 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2015-10-01 | 2199-12-31 |
| 38232 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2014-01-01 | 2199-12-31 |
| 99446 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2014-01-01 | 2199-12-31 |
| 99447 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2014-01-01 | 2199-12-31 |
| 99448 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2014-01-01 | 2199-12-31 |
| 99449 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2014-01-01 | 2199-12-31 |
| 38243 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-01-01 | 2199-12-31 |
| 76942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38221 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 76998 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2012-01-01 | 2199-12-31 |
| 93925 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 93926 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38220 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38205 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38204 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 0265T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38230 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38240 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38242 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
| 38241 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2199-12-31 |
Column 2 Pairs 0264T is the bundled code
When 0264T 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 |
|---|---|---|---|---|
| 0263T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2012-01-01 | 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 |
|---|---|---|---|---|
| 0263T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2012-01-01 | 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 |
|---|---|---|---|---|
| 0263T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2012-01-01 | 2199-12-31 |
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