NCCI Code Pairs — 86816
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 86816.
54 Total Edits
2 as Column 1
52 as Column 2
← View HCPCS 86816 Detail Page
Column 1 Pairs 86816 is the primary code
When 86816 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Practitioner — 1 pair
| 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 |
Medicaid Practitioner — 1 pair
| 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 |
Column 2 Pairs 86816 is the bundled code
When 86816 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 |
|---|---|---|---|---|
| 81380 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81381 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81375 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81376 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81377 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81378 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81372 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81373 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81382 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81383 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81370 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81371 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 86817 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1996-01-01 | 2199-12-31 |
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 |
|---|---|---|---|---|
| 81380 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81381 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81371 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81383 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81382 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81378 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81377 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81376 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81375 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81373 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81370 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81372 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 86817 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1996-01-01 | 2199-12-31 |
Medicaid Facility — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 81381 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81380 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81370 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81371 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81372 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81373 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81375 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81376 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81377 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81378 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81382 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81383 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 86817 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 13 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 81380 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81381 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2013-04-01 | 2199-12-31 |
| 81371 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81383 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81382 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81376 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81373 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81370 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81372 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81375 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81378 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 81377 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2013-01-01 | 2199-12-31 |
| 86817 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2010-10-01 | 2199-12-31 |
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