NCCI Code Pairs — 88738
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 88738.
36 Total Edits
10 as Column 1
26 as Column 2
← View HCPCS 88738 Detail Page
Column 1 Pairs 88738 is the primary code
When 88738 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 2 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 88741 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 88740 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 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 |
|---|---|---|---|---|
| 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 |
| 88740 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 88741 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
Medicaid Facility — 2 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 88740 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 88741 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 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 |
|---|---|---|---|---|
| 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 |
| 88740 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 88741 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Column 2 Pairs 88738 is the bundled code
When 88738 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) — 7 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0631T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2021-01-01 | 2025-12-31 |
| 0061U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2019-01-01 | 2199-12-31 |
| 85013 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 85014 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 85018 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 85025 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-01-01 | 2199-12-31 |
| 85027 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-01-01 | 2199-12-31 |
Medicare Practitioner — 5 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 85013 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 85027 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-01-01 | 2199-12-31 |
| 85025 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-01-01 | 2199-12-31 |
| 85018 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
| 85014 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-01-01 | 2199-12-31 |
Medicaid Facility — 7 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0631T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2021-01-01 | 2025-12-31 |
| 0061U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2019-01-01 | 2199-12-31 |
| 85014 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 85018 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 85025 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 85013 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 85027 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
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 |
|---|---|---|---|---|
| 0631T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2021-01-01 | 2025-12-31 |
| 0061U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
More extensive procedure | 2019-01-01 | 2199-12-31 |
| 85027 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 85025 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2199-12-31 |
| 85018 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 85014 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 85013 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
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