NCCI Code Pairs — 97265
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 97265.
32 Total Edits
8 as Column 1
24 as Column 2
← View HCPCS 97265 Detail Page
Column 1 Pairs 97265 is the primary code
When 97265 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 97260 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-10-01 | 1999-03-31 |
| 98942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
| 98940 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
| 98941 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
Medicare Practitioner — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 97260 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-10-01 | 1999-03-31 |
| 98942 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
| 98941 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
| 98940 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 1997-04-01 | 1999-03-31 |
Column 2 Pairs 97265 is the bundled code
When 97265 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) — 12 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 98929 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 97250 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98925 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98926 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98927 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98928 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 97504 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-07-01 | 1999-03-31 |
| 97112 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97113 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97116 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97110 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97545 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
Medicare Practitioner — 12 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 98929 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 97250 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98925 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98926 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98927 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 98928 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-10-01 | 1999-03-31 |
| 97504 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 1997-07-01 | 1999-03-31 |
| 97112 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97113 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97116 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97545 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
| 97110 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 1997-04-01 | 1999-03-31 |
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