NCCI Code Pairs — G0242
Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code G0242.
256 Total Edits
205 as Column 1
51 as Column 2
← View HCPCS G0242 Detail Page
Column 1 Pairs G0242 is the primary code
When G0242 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.
Medicare Facility (Hospital Outpatient) — 73 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0083T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2005-01-01 | 2005-12-31 |
| 20660 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2002-10-01 | 2005-12-31 |
| 20661 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 20693 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 20694 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61304 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61305 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61312 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61313 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61314 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61315 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61321 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61330 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61332 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61333 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61440 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61458 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61460 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61480 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61490 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77328 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61510 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61512 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61514 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61516 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61518 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61519 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61520 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61521 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61522 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61524 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61526 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61563 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61564 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61735 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61795 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61862 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2002-10-01 | 2004-03-31 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2005-12-31 |
| 77326 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77327 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77332 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77333 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77334 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77432 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2002-10-01 | 2005-12-31 |
| 61500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77310 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77285 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77290 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77295 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77300 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77305 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77315 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77321 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77413 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77414 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77416 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77336 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77370 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77401 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77402 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77403 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77404 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77406 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77407 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77408 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77409 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77411 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77412 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77280 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
Medicare Practitioner — 132 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0083T · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2005-01-01 | 2005-12-31 |
| 99332 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 20660 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
CPT Separate procedure definition | 2002-10-01 | 2005-12-31 |
| 20661 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 20693 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 20694 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61304 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61305 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61312 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61313 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61314 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61315 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61320 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61321 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61330 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61332 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61333 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61440 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61450 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61458 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61460 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61480 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61490 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61500 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61510 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61512 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61514 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61516 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61518 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61519 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61520 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61521 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61522 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61524 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61526 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61530 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61563 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61564 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61735 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61795 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61862 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2002-10-01 | 2004-03-31 |
| 69990 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2002-10-01 | 2005-12-31 |
| 99347 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99348 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99349 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99354 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99355 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99356 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99357 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99360 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77326 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77327 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77328 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77332 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77333 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77334 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Standards of medical/surgical practice | 2002-10-01 | 2002-10-01 |
| 77432 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
More extensive procedure | 2002-10-01 | 2005-12-31 |
| 99201 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99202 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99203 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99204 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99205 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99211 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99212 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99213 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99214 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99215 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99217 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99218 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99219 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99220 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99221 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99222 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99223 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99231 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99232 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99233 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99238 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99239 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99271 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99272 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99273 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99274 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99275 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99281 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99282 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99283 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99284 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99285 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99291 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99292 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99301 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99302 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99303 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99311 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99312 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99313 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99315 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99316 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99321 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99322 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99323 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99331 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99333 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99341 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99342 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 99343 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77305 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77310 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77315 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77321 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77416 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77285 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77280 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77300 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77295 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77290 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77336 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77370 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77401 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77402 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77403 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77404 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77406 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77407 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77408 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77409 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77411 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77412 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77413 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
| 77414 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-07-01 | 2005-12-31 |
Column 2 Pairs G0242 is the bundled code
When G0242 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) — 26 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| 0073T · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Misuse of Column Two code with Column One code | 2005-01-01 | 2005-12-31 |
| G0338 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-07-01 | 2005-12-31 |
| 61863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-01-01 | 2005-12-31 |
| 61867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-01-01 | 2005-12-31 |
| G0251 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 2003-07-01 | 2003-07-01 |
| 61751 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61760 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61770 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61790 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61791 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77418 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77427 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77431 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| G0173 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 2002-10-01 | 2002-10-01 |
| 61250 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61720 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61750 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61107 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61140 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61150 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61151 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61105 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
Medicare Practitioner — 25 pairs
| Paired Code |
Mod
Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
|
Rationale | Effective | End Date |
|---|---|---|---|---|
| G0338 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-07-01 | 2005-12-31 |
| 61867 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-01-01 | 2005-12-31 |
| 61863 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2004-01-01 | 2005-12-31 |
| G0251 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 2003-07-01 | 2003-07-01 |
| 77418 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 77427 · CCI |
0
Modifier not allowed — codes cannot be reported together under any circumstances
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77431 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 77470 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| G0173 · CCI |
9
Not applicable — edit has been deleted or is no longer active
|
Mutually exclusive procedures | 2002-10-01 | 2002-10-01 |
| 61105 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61107 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61120 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61140 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61150 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61151 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61250 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61253 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61501 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61720 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61750 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61751 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61760 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61770 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Standards of medical/surgical practice | 2002-10-01 | 2005-12-31 |
| 61790 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
| 61791 · CCI |
1
Modifier allowed — a NCCI-associated modifier may permit separate reporting
|
Mutually exclusive procedures | 2002-10-01 | 2005-12-31 |
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