NCCI Code Pairs — 87804
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 87804.
84 Total Edits
26 as Column 1
58 as Column 2
← View HCPCS 87804 Detail Page
Column 1 Pairs 87804 is the primary code
When 87804 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 |
|---|---|---|---|---|
| 80503 · 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 |
| 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 |
| 80502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2003-01-01 | 2021-12-31 |
| 80500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2003-01-01 | 2021-12-31 |
Medicare Practitioner — 7 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 80503 · 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 |
| 80505 · 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 |
| 80502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2003-01-01 | 2021-12-31 |
| 80500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2003-01-01 | 2021-12-31 |
Medicaid Facility — 6 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 |
| 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 |
| 80506 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2022-01-01 | 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 — 7 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 80503 · 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 |
| 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 |
| 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 |
| 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 87804 is the bundled code
When 87804 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 |
|---|---|---|---|---|
| 0225U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2022-07-01 | 2199-12-31 |
| 87428 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87636 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87637 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 0202U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2021-07-01 | 2199-12-31 |
| 0151U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2021-01-01 | 2022-09-30 |
| 0115U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 87631 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87633 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87632 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87276 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-04-01 | 2199-12-31 |
| 87400 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-04-01 | 2199-12-31 |
| 87275 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-01-01 | 2199-12-31 |
Medicare Practitioner — 11 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 87636 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87637 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87428 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87633 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87631 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87632 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87400 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-04-01 | 2199-12-31 |
| 87276 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-04-01 | 2199-12-31 |
| 87275 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2003-01-01 | 2199-12-31 |
Medicaid Facility — 16 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0225U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2022-07-01 | 2199-12-31 |
| 87428 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87637 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87636 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 0202U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2021-07-01 | 2199-12-31 |
| 0151U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2021-01-01 | 2022-09-30 |
| 0115U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 87631 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87633 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87632 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87503 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2015-01-01 | 2199-12-31 |
| 87501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87276 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 87275 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 87400 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 16 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0225U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2022-07-01 | 2199-12-31 |
| 87637 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87636 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 87428 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2022-01-01 | 2199-12-31 |
| 0202U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2021-07-01 | 2199-12-31 |
| 0151U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2021-01-01 | 2022-09-30 |
| 0115U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2020-01-01 | 2199-12-31 |
| 87633 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87631 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87632 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2017-01-01 | 2199-12-31 |
| 87503 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2015-01-01 | 2199-12-31 |
| 87501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87502 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2012-07-01 | 2199-12-31 |
| 87275 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 87400 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 87276 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Automate NCCI edit checking
Bedrock Billing validates CCI code pairs, modifier requirements, and bundling logic automatically.
Try Bedrock Billing for Free