NCCI Code Pairs — 56304
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 56304.
38 Total Edits
12 as Column 1
26 as Column 2
← View HCPCS 56304 Detail Page
Column 1 Pairs 56304 is the primary code
When 56304 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 6 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 56310 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 56360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 1997-03-31 |
| 56300 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 1996-01-01 | 2000-06-30 |
| 57410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 2000-06-30 |
| 56361 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 1997-03-31 |
| 56350 · 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Not applicable — edit has been deleted or is no longer active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 — 6 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 56310 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 56361 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 1997-03-31 |
| 56360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 1997-03-31 |
| 56350 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 56300 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 1996-01-01 | 2000-06-30 |
| 57410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 2000-06-30 |
Column 2 Pairs 56304 is the bundled code
When 56304 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) — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 58740 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 1999-07-01 | 2000-06-30 |
| 56314 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 56349 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 58180 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 2000-06-30 |
| 58200 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58210 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58240 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58950 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58951 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58262 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 56344 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 58263 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 56343 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
Medicare Practitioner — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 58740 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 1999-07-01 | 2000-06-30 |
| 56349 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 56314 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 1999-01-01 | 2000-06-30 |
| 58951 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58180 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 2000-06-30 |
| 58200 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58210 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58240 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58950 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Sequential procedure | 1997-04-01 | 2000-06-30 |
| 58263 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 56343 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 56344 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
| 58262 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2000-06-30 |
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