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NCCI Code Pairs — 87209

Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 87209.

50 Total Edits 38 as Column 1 12 as Column 2
← View HCPCS 87209 Detail Page

Column 1 Pairs 87209 is the primary code

When 87209 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 9 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
88388 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2024-12-31
88387 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2199-12-31
87207 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2007-04-01 2199-12-31
80500 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2007-04-01 2021-12-31
80502 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2007-04-01 2021-12-31
Medicare Practitioner — 10 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
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
88387 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2199-12-31
88388 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2024-12-31
80502 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2007-04-01 2021-12-31
87207 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2007-04-01 2199-12-31
80500 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2007-04-01 2021-12-31
Medicaid Facility — 9 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
88387 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2199-12-31
88388 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2024-12-31
87207 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2010-10-01 2199-12-31
80500 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2021-12-31
80502 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2021-12-31
Medicaid Practitioner — 10 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
80506 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80505 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80504 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
80503 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
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
88388 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2024-12-31
88387 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
CPT Manual or CMS manual coding instruction 2011-07-01 2199-12-31
87207 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2010-10-01 2199-12-31
80502 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2021-12-31
80500 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2021-12-31

Column 2 Pairs 87209 is the bundled code

When 87209 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
88321 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 2199-12-31
88323 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 2199-12-31
88325 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 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
88325 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 2199-12-31
88323 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 2199-12-31
88321 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2007-04-01 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
88323 · 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
88325 · 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
88321 · 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
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
88325 · 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
88323 · 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
88321 · 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

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