NCCI Code Pairs — 49905
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 49905.
102 Total Edits
90 as Column 1
12 as Column 2
← View HCPCS 49905 Detail Page
Column 1 Pairs 49905 is the primary code
When 49905 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 24 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 44604 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44603 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44180 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2006-01-01 | 2199-12-31 |
| 44005 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49570 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2022-12-31 |
| 49400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 44850 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 44200 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2005-12-31 |
| 49255 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49002 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2004-07-01 | 2004-12-31 |
| 44820 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 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 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2003-01-01 | 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 |
| 49906 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 1998-01-01 | 2199-12-31 |
| 49010 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 49000 · 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 |
| 44850 · 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 — 27 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 |
| 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 |
| 44602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44604 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44603 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2010-10-01 | 2199-12-31 |
| 44180 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2006-01-01 | 2199-12-31 |
| 49000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 44850 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49002 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2004-07-01 | 2004-12-31 |
| 49010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49255 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 49570 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2022-12-31 |
| 44005 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2004-07-01 | 2199-12-31 |
| 44200 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 2005-12-31 |
| 44820 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2004-07-01 | 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 |
| 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 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2199-12-31 |
| 49906 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 1998-01-01 | 2199-12-31 |
| 49570 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 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 |
| 44850 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
CPT Separate procedure definition | 1997-01-01 | 1997-01-01 |
| 49000 · 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 — 19 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 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 |
| 69990 · 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 |
| 44602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 44605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44604 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44603 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 49255 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 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 |
| 44005 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44180 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44820 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44850 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49570 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2022-12-31 |
| 49906 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 20 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 |
| 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 |
| 69990 · 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 |
| 44603 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44602 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44604 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 44605 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2011-01-01 | 2199-12-31 |
| 49320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2011-01-01 | 2199-12-31 |
| 44820 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44180 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44005 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 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 |
| 49570 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2022-12-31 |
| 49906 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 49400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49255 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49010 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 49000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
| 44850 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Separate procedure definition | 2010-10-01 | 2199-12-31 |
Column 2 Pairs 49905 is the bundled code
When 49905 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) — 3 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 44700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2016-07-01 | 2199-12-31 |
| 49904 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-07-01 | 2199-12-31 |
| 47700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2003-01-01 | 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 |
|---|---|---|---|---|
| 44700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2016-07-01 | 2199-12-31 |
| 49904 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-07-01 | 2199-12-31 |
| 47700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2003-01-01 | 2199-12-31 |
Medicaid Facility — 3 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 44700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2016-07-01 | 2199-12-31 |
| 47700 · 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 |
| 49904 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 3 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 44700 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2016-07-01 | 2199-12-31 |
| 49904 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 47700 · 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 |
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