NCCI Code Pairs — 43635
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 43635.
268 Total Edits
232 as Column 1
36 as Column 2
← View HCPCS 43635 Detail Page
Column 1 Pairs 43635 is the primary code
When 43635 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 83 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 43266 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43206 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2013-01-01 | 2199-12-31 |
| 44970 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2011-10-01 | 2199-12-31 |
| 38101 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 38120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 38100 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2199-12-31 |
| 43238 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2004-01-01 | 2199-12-31 |
| G0272 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2004-03-31 |
| 43256 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2013-12-31 |
| 43231 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 44950 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 43232 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43240 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43242 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43651 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2001-07-01 | 2007-12-31 |
| 43652 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2001-07-01 | 2007-12-31 |
| 44850 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 49570 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 44010 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 49010 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 43500 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 43830 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 43840 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 49255 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 49000 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 44950 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 44005 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 43860 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 1996-01-01 | 1996-01-01 |
| 43247 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43248 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43250 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43251 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43255 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43258 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43259 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43605 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43610 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43611 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43640 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43750 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43760 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43810 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43820 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43825 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43832 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 38100 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 38500 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43200 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43202 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43204 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43205 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43215 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43216 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43217 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43219 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43220 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43226 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43227 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43228 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43234 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43235 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43239 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43241 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43243 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43244 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43245 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43246 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
Medicare Practitioner — 86 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 43253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43266 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43206 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2013-01-01 | 2199-12-31 |
| 44970 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2011-10-01 | 2199-12-31 |
| 38120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 38101 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 38100 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2199-12-31 |
| 43238 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2004-01-01 | 2199-12-31 |
| G0272 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2004-03-31 |
| 43232 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 44950 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2002-04-01 | 2199-12-31 |
| 43242 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43231 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43256 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2013-12-31 |
| 43240 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-04-01 | 2199-12-31 |
| 43651 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2001-07-01 | 2007-12-31 |
| 43652 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2001-07-01 | 2007-12-31 |
| 43500 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 49010 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 49570 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 44010 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 44850 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 43220 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43226 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43227 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43228 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43234 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43235 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43239 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43241 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43243 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43244 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43245 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43246 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43247 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43248 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43250 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43251 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43255 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43258 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43259 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43605 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43610 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43611 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43640 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
More extensive procedure | 1996-01-01 | 1996-01-01 |
| 43750 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43760 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43810 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43820 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43825 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43830 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 43832 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43840 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43860 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 1996-01-01 | 1996-01-01 |
| 44005 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 44950 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 49000 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 49255 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1996-01-01 | 1996-01-01 |
| 38100 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 38500 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43200 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43202 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43204 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43205 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43215 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43216 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43217 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 43219 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
Medicaid Facility — 31 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 43266 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43206 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2013-01-01 | 2199-12-31 |
| 44970 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2011-10-01 | 2199-12-31 |
| 38100 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 38101 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 38120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 43242 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43238 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43232 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43231 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44950 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 43752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2199-12-31 |
| 43256 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2013-12-31 |
| 43240 · 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 — 32 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 43266 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2014-01-01 | 2199-12-31 |
| 43206 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2013-01-01 | 2199-12-31 |
| 44970 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2011-10-01 | 2199-12-31 |
| 38100 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 38101 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 38120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44950 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 43256 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2013-12-31 |
| 43242 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43240 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43238 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43232 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43231 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 43752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2199-12-31 |
Column 2 Pairs 43635 is the bundled code
When 43635 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) — 9 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43651 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2008-01-01 | 2199-12-31 |
| 43641 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 43640 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 43620 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2008-01-01 | 2199-12-31 |
| 64760 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 64755 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 64752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2008-01-01 | 2014-12-31 |
| 43652 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2008-01-01 | 2199-12-31 |
| 43621 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2008-01-01 | 2199-12-31 |
Medicare Practitioner — 9 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43652 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2008-01-01 | 2199-12-31 |
| 64755 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 64760 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 43620 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2008-01-01 | 2199-12-31 |
| 43621 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2008-01-01 | 2199-12-31 |
| 64752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2008-01-01 | 2014-12-31 |
| 43641 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 43640 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2008-01-01 | 2199-12-31 |
| 43651 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2008-01-01 | 2199-12-31 |
Medicaid Facility — 9 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 64760 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 43641 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 43651 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 43652 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 64752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2014-12-31 |
| 43640 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 43620 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 43621 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 64755 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 9 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 43621 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 43620 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2199-12-31 |
| 64760 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 64755 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 64752 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2014-12-31 |
| 43652 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 43651 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 43641 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 43640 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
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