NCCI Code Pairs — 95903
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 95903.
76 Total Edits
20 as Column 1
56 as Column 2
← View HCPCS 95903 Detail Page
Column 1 Pairs 95903 is the primary code
When 95903 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 5 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 95939 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95938 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95905 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-01-01 | 2012-12-31 |
| 95920 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2012-12-31 |
| 95900 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2012-12-31 |
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 |
|---|---|---|---|---|
| 95939 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95938 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95905 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-01-01 | 2012-12-31 |
| 95920 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2012-12-31 |
| 95900 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-01-01 | 2012-12-31 |
Medicaid Facility — 5 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 95938 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95939 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95905 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2012-12-31 |
| 95900 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2012-12-31 |
| 95920 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2012-12-31 |
Medicaid Practitioner — 5 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 95939 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95938 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-01-01 |
| 95905 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 2010-10-01 | 2012-12-31 |
| 95900 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2012-12-31 |
| 95920 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2010-10-01 | 2012-12-31 |
Column 2 Pairs 95903 is the bundled code
When 95903 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 |
|---|---|---|---|---|
| 95867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 90869 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95860 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95861 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95864 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95870 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95869 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95868 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 90867 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 90868 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 96020 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2008-04-01 | 2012-12-31 |
| 0161T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2007-01-01 | 2010-12-31 |
| 0160T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2007-01-01 | 2010-12-31 |
| 95904 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
HCPCS/CPT procedure code definition | 2000-06-05 | 2000-06-05 |
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 |
|---|---|---|---|---|
| 95863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 90869 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95860 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95861 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95864 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95868 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95869 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 95870 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Manual or CMS manual coding instruction | 2012-01-01 | 2012-12-31 |
| 90868 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 90867 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 96020 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2008-04-01 | 2012-12-31 |
| 95904 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
HCPCS/CPT procedure code definition | 2000-06-05 | 2000-06-05 |
Medicaid Facility — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 95860 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95861 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95864 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95868 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95869 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95870 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 90869 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 90867 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 90868 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 96020 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2012-12-31 |
| 0160T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2010-12-31 |
| 0161T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2010-12-31 |
Medicaid Practitioner — 14 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 95869 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95868 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95864 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95861 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95860 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 90869 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 95870 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2012-01-01 | 2012-12-31 |
| 90868 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 90867 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2011-01-01 | 2012-12-31 |
| 0161T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2010-12-31 |
| 96020 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2012-12-31 |
| 0160T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2010-12-31 |
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