NCCI Code Pairs — G0103
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code G0103.
22 Total Edits
16 as Column 1
6 as Column 2
← View HCPCS G0103 Detail Page
Column 1 Pairs G0103 is the primary code
When G0103 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 |
|---|---|---|---|---|
| 0433U · 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 |
| 0424U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2025-01-01 | 2199-12-31 |
| 84154 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2001-01-01 | 2199-12-31 |
| 84153 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2001-01-01 | 2199-12-31 |
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 |
|---|---|---|---|---|
| 0424U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2025-01-01 | 2199-12-31 |
| 0433U · 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 |
| 84153 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2001-01-01 | 2199-12-31 |
| 84154 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2001-01-01 | 2199-12-31 |
Medicaid Facility — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0433U · 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 |
| 0424U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2025-01-01 | 2199-12-31 |
| 84153 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 84154 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Medicaid Practitioner — 4 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0433U · 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 |
| 0424U · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2025-01-01 | 2199-12-31 |
| 84154 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
| 84153 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2010-10-01 | 2199-12-31 |
Column 2 Pairs G0103 is the bundled code
When G0103 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) — 2 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0495U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0403U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 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 |
|---|---|---|---|---|
| 0495U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0403U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
Medicaid Practitioner — 2 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0495U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2026-04-01 | 2199-12-31 |
| 0403U · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Misuse of Column Two code with Column One code | 2024-10-01 | 2199-12-31 |
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