NCCI Code Pairs — 48160
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 48160.
72 Total Edits
72 as Column 1
← View HCPCS 48160 Detail Page
Column 1 Pairs 48160 is the primary code
When 48160 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 16 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2016-10-01 | 2199-12-31 |
| 49321 · 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 |
Medicare Practitioner — 19 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 |
| 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 |
| 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 |
| 49321 · 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 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 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 |
| 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 |
| 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 |
Medicaid Facility — 18 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 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 |
| 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 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2016-10-01 | 2199-12-31 |
| 49321 · 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 |
| 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 |
Medicaid Practitioner — 19 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 |
| 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 |
| 49321 · 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 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 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 |
| 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 |
| 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 |
| 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 |
| 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 |
| 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 |
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