NCCI Code Pairs — 0497U
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 0497U.
113 Total Edits
98 as Column 1
15 as Column 2
← View HCPCS 0497U Detail Page
Column 1 Pairs 0497U is the primary code
When 0497U is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 54 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0343U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 0359U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 96523 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2026-07-01 | 2199-12-31 |
| G0452 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 0228U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 36591 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2026-07-01 | 2199-12-31 |
| 36592 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2026-07-01 | 2199-12-31 |
| 81427 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81445 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81449 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81455 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81456 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81539 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 81551 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 84311 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88271 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88272 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88273 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88274 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88275 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88291 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88366 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 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 | 2026-07-01 | 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 | 2026-07-01 | 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 | 2026-07-01 | 2199-12-31 |
| 0239U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 0244U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 88367 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 0005U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 0339U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-07-01 | 2199-12-31 |
| 0340U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-07-01 | 2199-12-31 |
| 81283 · 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 |
| 0011M · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0021U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0047U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0113U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0169U · 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 |
| 0286U · 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 |
| 0403U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0433U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0475U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81228 · 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 |
| 81229 · 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 |
| 81313 · 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 |
| 81400 · 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 |
| 81401 · 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 |
| 81402 · 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 |
| 81403 · 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 |
| 81404 · 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 |
| 81405 · 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 |
| 81406 · 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 |
| 81407 · 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 |
| 81408 · 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 — 22 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0286U · 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 |
| 0011M · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0021U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0047U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0113U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0169U · 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 |
| 0403U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0433U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0475U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81228 · 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 |
| 81229 · 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 |
| 81283 · 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 |
| 81313 · 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 |
| 81400 · 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 |
| 81401 · 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 |
| 81402 · 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 |
| 81403 · 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 |
| 81404 · 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 |
| 81405 · 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 |
| 81406 · 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 |
| 81407 · 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 |
| 81408 · 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 — 22 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 81408 · 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 |
| 81407 · 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 |
| 0011M · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0021U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0047U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81406 · 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 |
| 0113U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0169U · 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 |
| 0286U · 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 |
| 0403U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0433U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 0475U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81228 · 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 |
| 81229 · 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 |
| 81283 · 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 |
| 81313 · 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 |
| 81400 · 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 |
| 81401 · 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 |
| 81402 · 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 |
| 81403 · 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 |
| 81404 · 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 |
| 81405 · 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 |
Column 2 Pairs 0497U is the bundled code
When 0497U 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) — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0242U · 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 |
| 81415 · 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 |
| 81425 · 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 |
| 81541 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
Medicare Practitioner — 3 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 81415 · 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 |
| 81541 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81425 · 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 — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0242U · 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 |
| 81415 · 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 |
| 81425 · 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 |
| 81541 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 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 |
|---|---|---|---|---|
| 81415 · 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 |
| 81541 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2026-04-01 | 2199-12-31 |
| 81425 · 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 |
| 0242U · 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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