NCCI Code Pairs — 55859
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 55859.
95 Total Edits
65 as Column 1
30 as Column 2
← View HCPCS 55859 Detail Page
Column 1 Pairs 55859 is the primary code
When 55859 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 29 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 90765 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90772 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90774 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90775 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| C8950 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| C8952 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90760 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 64416 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2006-12-31 |
| 76942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2006-12-31 |
| 51701 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 51702 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 51703 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 64470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2006-12-31 |
| 36410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2006-12-31 |
| 37202 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64475 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 62318 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 62319 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64415 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64417 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 55873 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2001-07-01 | 2002-03-31 |
| 53675 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2003-03-31 |
| 53670 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2003-03-31 |
| P9612 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2006-12-31 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2000-07-01 | 2006-12-31 |
| 52250 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2006-12-31 |
| 52000 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
Medicare Practitioner — 36 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 90775 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90774 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90765 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| C8952 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| C8950 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90760 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| 90772 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2006-01-01 | 2006-12-31 |
| G0354 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2005-07-01 | 2005-12-31 |
| G0353 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2005-07-01 | 2005-12-31 |
| G0351 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2005-07-01 | 2005-12-31 |
| G0347 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2005-01-01 | 2005-12-31 |
| G0345 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2005-01-01 | 2005-12-31 |
| 76942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2006-12-31 |
| 51703 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 51701 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 51702 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2003-01-01 | 2006-12-31 |
| 64416 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2003-01-01 | 2006-12-31 |
| 64450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2006-12-31 |
| 36410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2006-12-31 |
| 37202 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 62318 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 62319 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64415 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64417 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 64475 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2006-12-31 |
| 90780 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2004-12-31 |
| 00860 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Anesthesia service included in surgical procedure | 2002-07-01 | 2006-12-31 |
| 55873 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2001-07-01 | 2002-03-31 |
| P9612 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2006-12-31 |
| 53675 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2003-03-31 |
| 53670 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2000-10-01 | 2003-03-31 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2000-07-01 | 2006-12-31 |
| 52250 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2006-12-31 |
| 52000 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
Column 2 Pairs 55859 is the bundled code
When 55859 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) — 15 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 55866 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2004-07-01 | 2006-12-31 |
| G0256 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2003-01-01 | 2004-03-31 |
| G0261 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Anesthesia service included in surgical procedure | 2003-01-01 | 2004-03-31 |
| 55873 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2002-04-01 | 2006-12-31 |
| 55801 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55821 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55831 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55840 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55842 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55845 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55860 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55862 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55810 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55812 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55815 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
Medicare Practitioner — 15 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 55866 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2004-07-01 | 2006-12-31 |
| G0261 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Anesthesia service included in surgical procedure | 2003-01-01 | 2004-03-31 |
| G0256 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2003-01-01 | 2004-03-31 |
| 55873 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2002-04-01 | 2006-12-31 |
| 55821 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55815 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55812 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55810 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55860 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55862 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55801 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55845 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55842 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55840 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
| 55831 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2006-12-31 |
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