NCCI Code Pairs — A9538
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code A9538.
111 Total Edits
4 as Column 1
107 as Column 2
← View HCPCS A9538 Detail Page
Column 1 Pairs A9538 is the primary code
When A9538 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 1 pair
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| A9512 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2010-07-01 | 2199-12-31 |
Medicare Practitioner — 1 pair
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| A9512 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2010-07-01 | 2199-12-31 |
Medicaid Facility — 1 pair
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| A9512 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 1 pair
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| A9512 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2010-10-01 | 2199-12-31 |
Column 2 Pairs A9538 is the bundled code
When A9538 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) — 27 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0868T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 78597 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78266 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78265 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78481 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78070 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78202 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2019-12-31 |
| 78215 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78264 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78278 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78290 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78305 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78451 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78452 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78472 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78473 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78483 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78494 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78580 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78582 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78598 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78709 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78808 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78815 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
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 |
|---|---|---|---|---|
| 78265 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78266 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78597 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78215 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78070 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78202 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2019-12-31 |
| 78451 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78305 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78290 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78278 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78264 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78815 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78808 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78709 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78598 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78582 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78580 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78494 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78483 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78481 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78473 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78472 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78452 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
Medicaid Facility — 27 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0868T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 78266 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78265 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78597 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78202 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78070 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2019-12-31 |
| 78215 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78264 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78278 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78290 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78305 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78451 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78452 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78472 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78473 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78481 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78483 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78494 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78580 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78582 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78598 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78709 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78808 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78815 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
Medicaid Practitioner — 27 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0868T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2025-01-01 | 2199-12-31 |
| 78265 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78597 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78266 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2016-01-01 | 2199-12-31 |
| 78815 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78808 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78709 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78598 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78582 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2015-10-01 |
| 78580 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78494 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78483 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78481 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78473 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78472 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78452 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78451 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78305 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78290 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78278 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78227 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78070 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78215 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78206 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2019-12-31 |
| 78202 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78226 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
| 78264 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2015-10-01 | 2199-12-31 |
Automate NCCI edit checking
Bedrock Billing validates CCI code pairs, modifier requirements, and bundling logic automatically.
Try Bedrock Billing for Free