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ncci_pairs_common.csv
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72 lines (72 loc) · 4.64 KB
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comprehensive_code,included_code,note
85025,85027,85025 CBC with diff includes 85027 CBC without diff; do not bill both
85025,85004,85025 CBC includes 85004 automated differential WBC count
85025,85007,85025 CBC includes 85007 manual differential WBC count
80053,80048,Comprehensive metabolic panel 80053 includes basic metabolic panel 80048
80053,84520,CMP 80053 includes BUN 84520
80053,82565,CMP 80053 includes creatinine 82565
80053,82435,CMP 80053 includes chloride 82435
80053,84132,CMP 80053 includes potassium 84132
80053,84295,CMP 80053 includes sodium 84295
80053,82947,CMP 80053 includes glucose 82947
80053,82310,CMP 80053 includes calcium 82310
80053,82040,CMP 80053 includes albumin 82040
80053,82247,CMP 80053 includes total bilirubin 82247
80053,84450,CMP 80053 includes AST 84450
80053,84460,CMP 80053 includes ALT 84460
80053,84075,CMP 80053 includes alkaline phosphatase 84075
80053,84155,CMP 80053 includes total protein 84155
80048,84520,BMP 80048 includes BUN 84520
80048,82565,BMP 80048 includes creatinine 82565
80048,82435,BMP 80048 includes chloride 82435
80048,84132,BMP 80048 includes potassium 84132
80048,84295,BMP 80048 includes sodium 84295
80048,82947,BMP 80048 includes glucose 82947
80048,82310,BMP 80048 includes calcium 82310
80048,82374,BMP 80048 includes carbon dioxide 82374
80061,82465,Lipid panel 80061 includes total cholesterol 82465
80061,84478,Lipid panel 80061 includes triglycerides 84478
80061,83718,Lipid panel 80061 includes HDL cholesterol 83718
80076,84450,Hepatic function panel 80076 includes AST 84450
80076,84460,Hepatic function panel 80076 includes ALT 84460
80076,82247,Hepatic function panel 80076 includes total bilirubin 82247
80076,84075,Hepatic function panel 80076 includes alkaline phosphatase 84075
80076,84155,Hepatic function panel 80076 includes total protein 84155
80076,82040,Hepatic function panel 80076 includes albumin 82040
80076,82248,Hepatic function panel 80076 includes direct bilirubin 82248
81003,81001,Automated urinalysis 81003 and UA with microscopy 81001 should not bill same DOS
81003,81002,Automated UA 81003 and UA without microscopy 81002 should not bill same DOS
81003,81005,Auto UA 81003 includes 81005 routine UA non-automated
93000,93005,EKG complete 93000 includes 93005 tracing only
93000,93010,EKG complete 93000 includes 93010 interpretation only
93005,93010,93005 tracing and 93010 interpretation are subcomponents of 93000 complete
71046,71045,Chest X-ray 2 views 71046 includes single view 71045
71046,71047,71046 2-view chest X-ray and 71047 3-view; bill the higher only, not both
72100,72020,Lumbar spine 2-3 views 72100 includes 72020 single view
73070,73060,Elbow X-ray 2 views 73070 includes 73060 single view
73080,73070,Elbow complete 73080 includes 2-view 73070 same DOS
73110,73100,Wrist complete min 3 views 73110 includes 73100 2 views
73130,73120,Hand min 3 views 73130 includes 73120 2 views
73510,73500,Hip complete 73510 includes 73500 single view
73560,73564,Knee 1-2 views 73560 includes 73564 complete 4+ views; bill higher only
73610,73600,Ankle complete min 3 views 73610 includes 73600 2 views
74176,74150,CT abdomen and pelvis without contrast 74176 includes 74150 CT abdomen alone
74176,72192,CT abdomen and pelvis 74176 includes 72192 CT pelvis alone
74177,74160,CT abd/pelvis with contrast 74177 includes 74160 CT abd with contrast
74178,74170,CT abd/pelvis with and without contrast 74178 includes 74170
70450,70470,CT head without contrast 70450 and 70470 with-and-without; do not bill both
70551,70552,MRI brain without contrast 70551 and with contrast 70552; choose one
70553,70551,MRI brain with and without contrast 70553 includes 70551 alone
99213,99212,Same E/M established patient level 3 and level 2 same day
99214,99213,Same E/M established patient level 4 and level 3 same day
99215,99214,Same E/M established patient level 5 and level 4 same day
99284,99283,Same ED visit level 4 and level 3 same day
99285,99284,Same ED visit level 5 and level 4 same day
99291,99285,Critical care 99291 and ED visit 99285 same day should not double bill unless documented separately
12011,12001,Simple repair face 2.5cm 12011 includes simple repair scalp 2.5cm 12001 if same anatomic location
12031,12001,Intermediate repair 12031 includes simple repair 12001 same wound
13100,12031,Complex repair 13100 includes intermediate repair 12031 same wound
36415,36410,Venipuncture routine 36415 includes 36410 venipuncture age 3-younger; choose by age
96365,96360,Therapeutic IV infusion 96365 and hydration 96360 may bundle when same access; verify documentation
96374,96360,IV push 96374 includes hydration 96360 if hydration was incidental to push
20610,20605,Arthrocentesis large joint 20610 includes intermediate 20605 same joint