NCCI Code Pairs — 96520
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 96520.
127 Total Edits
80 as Column 1
47 as Column 2
← View HCPCS 96520 Detail Page
Column 1 Pairs 96520 is the primary code
When 96520 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 35 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 77401 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77402 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77404 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77406 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77407 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77408 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77409 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77411 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77412 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77413 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77414 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77416 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77403 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 96400 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96405 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96406 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96408 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96410 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96412 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96420 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96422 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96423 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96425 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96440 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96445 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96450 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96542 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 77610 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 77615 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 77620 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 77605 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 96414 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 1996-01-01 | 1996-01-01 |
| 77600 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| A4214 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 99185 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 2005-12-31 |
Medicare Practitioner — 45 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 99211 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99204 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99203 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99202 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99201 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99205 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99215 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99214 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99213 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 99212 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-01-01 | 2005-12-31 |
| 77409 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77411 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77412 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77413 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77414 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77416 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77404 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77407 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77408 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77403 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77406 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 96400 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96405 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96406 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96408 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96410 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96412 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96420 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96422 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96423 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96425 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96440 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96445 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96450 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 96542 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1997-01-01 | 1997-01-01 |
| 77402 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77401 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 77615 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 77620 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 96414 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 1996-01-01 | 1996-01-01 |
| 77610 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 77605 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| A4214 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
| 99185 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1996-01-01 | 2005-12-31 |
| 77600 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 1996-01-01 | 1996-01-01 |
Column 2 Pairs 96520 is the bundled code
When 96520 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) — 21 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 62350 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-07-01 | 2005-12-31 |
| G0292 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2003-07-01 | 2004-12-31 |
| Q0085 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2003-01-01 | 2004-12-31 |
| 96425 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2002-07-01 | 2005-12-31 |
| 96414 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2002-07-01 | 2004-12-31 |
| 62365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-07-01 | 2005-12-31 |
| 96412 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96420 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96422 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96423 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96440 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96445 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96405 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96406 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96408 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96542 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 36260 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
| 36261 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-01-01 | 2005-12-31 |
Medicare Practitioner — 26 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| G0361 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2005-01-01 | 2005-12-31 |
| G0357 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2005-01-01 | 2005-12-31 |
| G0356 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2005-01-01 | 2005-12-31 |
| G0355 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2005-01-01 | 2005-12-31 |
| G0359 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2005-01-01 | 2005-12-31 |
| 62350 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2004-07-01 | 2005-12-31 |
| G0292 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 2003-07-01 | 2004-12-31 |
| Q0085 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2003-01-01 | 2004-12-31 |
| Q0083 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2003-01-01 | 2004-12-31 |
| Q0084 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2003-01-01 | 2004-12-31 |
| 96414 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2002-07-01 | 2004-12-31 |
| 96425 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
HCPCS/CPT procedure code definition | 2002-07-01 | 2005-12-31 |
| 62365 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-07-01 | 2005-12-31 |
| 96412 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96410 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96408 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96406 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96405 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96400 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2004-12-31 |
| 96450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96445 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96440 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
| 96423 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96422 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96420 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
HCPCS/CPT procedure code definition | 1997-01-01 | 2005-12-31 |
| 96542 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
CPT Manual or CMS manual coding instruction | 1997-01-01 | 2005-12-31 |
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