NCCI Code Pairs — 0406U
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 0406U.
96 Total Edits
52 as Column 1
44 as Column 2
← View HCPCS 0406U Detail Page
Column 1 Pairs 0406U is the primary code
When 0406U is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 18 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0478U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 0414U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 71271 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 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 | 2024-10-01 | 2199-12-31 |
| 83516 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83518 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83519 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83520 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88182 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88184 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88185 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88187 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88189 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88188 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 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 | 2024-07-01 | 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 | 2024-07-01 | 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 | 2024-07-01 | 2199-12-31 |
| 96523 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2024-07-01 | 2199-12-31 |
Medicaid Facility — 17 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0414U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 71271 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 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 | 2024-10-01 | 2199-12-31 |
| 83516 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83518 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83519 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83520 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88182 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88184 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88185 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88187 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88188 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88189 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 96523 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2024-07-01 | 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 | 2024-07-01 | 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 | 2024-07-01 | 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 | 2024-07-01 | 2199-12-31 |
Medicaid Practitioner — 17 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0414U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 71271 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 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 | 2024-10-01 | 2199-12-31 |
| 88182 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88184 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88185 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88187 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88188 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 88189 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83516 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83518 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83519 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 2199-12-31 |
| 83520 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2024-10-01 | 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 | 2024-07-01 | 2199-12-31 |
| 96523 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2024-07-01 | 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 | 2024-07-01 | 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 | 2024-07-01 | 2199-12-31 |
Column 2 Pairs 0406U is the bundled code
When 0406U 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) — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0460U · 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 |
| 0461U · 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 |
| 0474U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2025-10-01 | 2199-12-31 |
| 0436U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 0360U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0092U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0080U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0022U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 81538 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0179U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0288U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0317U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0395U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
| 81235 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
Medicare Practitioner — 2 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 81538 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 81235 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
Medicaid Facility — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0461U · 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 |
| 0460U · 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 |
| 0474U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2025-10-01 | 2199-12-31 |
| 0436U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 0317U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0360U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 81538 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0022U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0080U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0092U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0179U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0288U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0395U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
| 81235 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
Medicaid Practitioner — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0461U · 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 |
| 0460U · 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 |
| 0474U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2025-10-01 | 2199-12-31 |
| 0436U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 0092U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0179U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0288U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0317U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0360U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 81538 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0022U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0080U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
| 0395U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
| 81235 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-07-01 | 2199-12-31 |
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