NCCI Code Pairs — 38746
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 38746.
181 Total Edits
128 as Column 1
53 as Column 2
← View HCPCS 38746 Detail Page
Column 1 Pairs 38746 is the primary code
When 38746 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 32 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 38531 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 11006 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11042 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11043 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11044 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11045 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11046 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11047 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97598 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11001 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97597 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11004 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11005 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 32674 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-07-01 | 2199-12-31 |
| 32551 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-10-01 | 2199-12-31 |
| 32607 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32608 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32609 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2011-12-31 |
| 32601 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 32605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2011-12-31 |
| 32606 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 39000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-04-01 | 2199-12-31 |
| 39010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-04-01 | 2199-12-31 |
| 38500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 38530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 60522 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 32002 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 32020 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 38530 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
Medicare Practitioner — 35 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 38531 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 11044 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11006 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11001 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11005 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11047 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97598 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11042 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97597 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11004 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11046 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11045 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11043 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 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 |
| 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 |
| 32674 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-07-01 | 2199-12-31 |
| 32551 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-10-01 | 2199-12-31 |
| 32608 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32609 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32607 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2199-12-31 |
| 32606 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 32605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2011-12-31 |
| 32602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2011-12-31 |
| 32601 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 39000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-04-01 | 2199-12-31 |
| 39010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-04-01 | 2199-12-31 |
| 38500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 38530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 38530 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 60522 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 32020 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 32002 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
Medicaid Facility — 30 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 38531 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 11000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97598 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97597 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11047 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11046 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11045 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11044 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11043 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11042 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11006 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11005 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11004 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11001 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 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 |
| 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 |
| 32674 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-07-01 | 2199-12-31 |
| 32551 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-10-01 | 2199-12-31 |
| 32608 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32607 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32609 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2011-12-31 |
| 32601 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 32606 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 32602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2011-12-31 |
| 38500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 38530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 39000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 39010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 31 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 38531 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2019-01-01 | 2199-12-31 |
| 11046 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11047 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11004 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11043 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11044 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11045 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11001 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97597 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97598 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 97602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11042 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11006 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 11005 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2016-10-01 | 2199-12-31 |
| 36591 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 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 |
| 32674 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-07-01 | 2199-12-31 |
| 32551 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-10-01 | 2199-12-31 |
| 32609 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32607 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32608 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2012-01-01 | 2199-12-31 |
| 32606 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 32601 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 32602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2011-12-31 |
| 32605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2011-12-31 |
| 38500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 39000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 39010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 38530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
Column 2 Pairs 38746 is the bundled code
When 38746 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 |
|---|---|---|---|---|
| 43286 · 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 |
| 43288 · 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 |
| 43113 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43124 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43123 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43122 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43121 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43118 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43117 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43116 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43112 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43108 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43107 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 21632 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
HCPCS/CPT procedure code definition | 1997-01-01 | 1997-01-01 |
Medicare Practitioner — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43286 · 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 |
| 43288 · 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 |
| 43121 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43107 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43108 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43112 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43113 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43116 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43117 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43118 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43122 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43123 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43124 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
Medicaid Facility — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43288 · 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 |
| 43286 · 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 |
| 43118 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43117 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43107 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43108 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43112 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43113 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43116 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43124 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43123 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43122 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43121 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
Medicaid Practitioner — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43288 · 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 |
| 43286 · 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 |
| 43113 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43112 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43124 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43117 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43118 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43108 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43121 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43122 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43107 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
| 43123 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2013-12-31 |
| 43116 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2013-10-01 | 2199-12-31 |
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