NCCI BUNDLING CHECKER

Do these two codes bundle?

Paste a CPT pair. Get the NCCI Procedure-to-Procedure verdict, the modifier indicator, and the modifier path that may bypass the edit when clinically supported.

Unknown code:

Verify the CPT format. Both codes must be valid Current Procedural Terminology codes (5 digits, or 4 digits + a letter for Category II/III).

READ THE INDICATORS

What the modifier indicator means

0
Hard bundle

The two codes cannot be unbundled under any circumstance. No modifier bypass is allowed. Bill only the column 1 code; write off the column 2 charge or do not submit it.

1
Modifier may bypass

A modifier (typically 59 or an X-modifier: XE, XS, XP, XU) can bypass the edit when documentation supports a distinct, separately identifiable service. Documentation is the deciding factor.

9
Not applicable

No modifier indicator is applicable to this code pair. The pair may not require a modifier decision, or the edit was retired by CMS. Always verify against the current NCCI quarterly file.

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