NCCI Code Pairs — 78430
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 78430.
75 Total Edits
59 as Column 1
16 as Column 2
← View HCPCS 78430 Detail Page
Column 1 Pairs 78430 is the primary code
When 78430 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0708T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 0709T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| A9555 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9526 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9503 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 96377 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96372 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 78459 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78445 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
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 |
|---|---|---|---|---|
| 0709T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 0708T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 36591 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 78459 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 96360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96372 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96377 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| A9500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9503 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9526 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9555 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 78445 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
Medicaid Facility — 15 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0708T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 0709T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 36591 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
| 78445 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 78459 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 96360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96372 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96377 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| A9500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9503 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9526 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9555 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
Medicaid Practitioner — 15 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0709T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| 0708T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 2199-12-31 |
| A9555 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9526 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9503 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2020-01-01 |
| A9502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| A9500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 96377 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96372 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 96360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 78459 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78445 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 36000 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2020-01-01 | 2199-12-31 |
| 36591 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2020-01-01 | 2199-12-31 |
Column 2 Pairs 78430 is the bundled code
When 78430 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) — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 78492 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2020-01-01 | 2199-12-31 |
| 78433 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78432 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 79101 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
Medicare Practitioner — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 78432 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 78433 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78492 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2020-01-01 | 2199-12-31 |
| 79101 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
Medicaid Facility — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 79101 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 78432 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 78433 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78492 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2020-01-01 | 2199-12-31 |
Medicaid Practitioner — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 78492 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2020-01-01 | 2199-12-31 |
| 78433 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 78432 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
| 79101 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2020-01-01 | 2199-12-31 |
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