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NCCI Code Pairs — M0243

Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code M0243.

12 Total Edits 12 as Column 1
← View HCPCS M0243 Detail Page

Column 1 Pairs M0243 is the primary code

When M0243 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
M0245 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2021-07-01 2025-09-30
Q0243 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Q0245 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Medicare Practitioner — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
M0245 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2021-07-01 2025-09-30
Q0243 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Q0245 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Medicaid Facility — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
M0245 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2021-07-01 2025-09-30
Q0243 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Q0245 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Medicaid Practitioner — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
M0245 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Mutually exclusive procedures 2021-07-01 2025-09-30
Q0243 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01
Q0245 · CCI
9 Not applicable — edit has been deleted or is no longer active
Mutually exclusive procedures 2021-07-01 2021-07-01

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