Reference
NCCI bundling edits
31 curated NCCI procedure-pair conflicts with bypass criteria + supporting documentation.
Edits indexed
31
| Code 1 | Code 2 | Pair | Bypass |
|---|---|---|---|
| 0780T | 99213 | E&M 99213 + RPM treatment management (0780T equivalent) | Modifier permitted |
| 11042 | 11043 | Debridement subcutaneous tissue (11042) + muscle/fascia (11043) | No bypass |
| 11102 | 11104 | Tangential biopsy (11102) + Punch biopsy (11104) | Modifier permitted |
| 20611 | 20610 | Joint injection major with ultrasound guidance (20611) + without guidance (20610) | No bypass |
| 29405 | 29425 | Short leg cast (29405) + short leg cast walking (29425) | No bypass |
| 29826 | 29827 | Arthroscopic decompression (29826) + rotator cuff repair (29827) | No bypass |
| 31231 | 31237 | Diagnostic nasal endoscopy (31231) + with biopsy (31237) | No bypass |
| 44950 | 44970 | Open appendectomy (44950) + laparoscopic appendectomy (44970) | No bypass |
| 45378 | 45380 | Colonoscopy diagnostic (45378) + with biopsy (45380) | No bypass |
| 45378 | 45385 | Colonoscopy diagnostic (45378) + polyp removal by snare (45385) | No bypass |
| 70450 | 70486 | CT head without contrast (70450) + CT sinuses without contrast (70486) | Modifier permitted |
| 76700 | 76705 | Abdominal ultrasound complete (76700) + limited (76705) | No bypass |
| 76942 | 20610 | Ultrasound guidance (76942) + Joint injection (20610) | No bypass |
| 88305 | 88307 | Pathology surgical level IV (88305) + level V (88307) | Modifier permitted |
| 90791 | 90792 | Psychiatric diagnostic eval (90791) + with med services (90792) | No bypass |
| 90832 | 90834 | Psychotherapy 30 min (90832) + 45 min (90834) | No bypass |
| 92002 | 92012 | Ophthalmologic exam new patient (92002) + established (92012) | No bypass |
| 93000 | 93005 | ECG with interpretation (93000) + tracing only (93005) | No bypass |
| 94010 | 94060 | Spirometry (94010) + with bronchodilator (94060) | No bypass |
| 97140 | 97110 | Manual therapy (97140) + therapeutic exercise (97110) | Modifier permitted |
| 99213 | 20610 | E&M 99213 + Joint injection 20610 | Modifier permitted |
| 99213 | 36415 | E&M 99213 + Venipuncture 36415 | Modifier permitted |
| 99213 | 81025 | E&M 99213 + Urine pregnancy test 81025 | Modifier permitted |
| 99213 | 90471 | E&M 99213 + Vaccine admin 90471 | Modifier permitted |
| 99213 | 93000 | E&M 99213 + ECG 93000 | Modifier permitted |
| 99213 | 94640 | E&M 99213 + Pressurized inhalation (94640) | Modifier permitted |
| 99213 | 96372 | E&M 99213 + Injection 96372 | Modifier permitted |
| 99213 | G0444 | E&M 99213 + Annual depression screening (G0444) | Modifier permitted |
| 99214 | 96372 | E&M 99214 + Injection 96372 | Modifier permitted |
| 99215 | 99417 | E&M 99215 + Prolonged services (99417) | No bypass |
| 99291 | 99292 | Critical care first hour (99291) + each additional 30 min (99292) | No bypass |
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