NCCI Bundling Checker
Can you bill those two codes together? Check any pair against the official Medicare NCCI edit file and get the verdict — bundled, modifier allowed, or no edit — in seconds.
"Can I bill these two codes together?" is the question behind a large share of procedure denials. Medicare's National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits bundle millions of code pairs: the Column 2 code is not separately payable with the Column 1 code unless an edit allows a modifier and the documentation supports it. Enter two codes and get the answer from the official edit file.
Check a code pair
How to read the verdict
- Modifier indicator 0 — never. No modifier can bypass the edit. The Column 2 service is considered an integral part of the Column 1 service; bill the Column 1 code only.
- Modifier indicator 1 — sometimes. A modifier may bypass the edit when the clinical circumstances genuinely justify it — for example modifier 59 (or the more specific X{E,S,P,U} modifiers) for a distinct procedural service, or modifier 25 on an E/M code. Documentation must support the distinct service; a modifier added just to force payment is an audit risk.
- Modifier indicator 9 — edit deleted. The edit is not active; the pair is not bundled under this edit.
- No edit found. The pair does not appear in the active PTP file. That is not a guarantee of payment — medically unlikely edits, MUE unit caps and payer-specific policies can still deny the line. Our Claim Scrubber Lite checks pairs, units and diagnoses together.
Data: CMS NCCI Procedure-to-Procedure edits for practitioner services, version effective October 1, 2026 (2026 Q4), active edits as of that date. Commercial payers often adopt NCCI edits but may add their own — always confirm against the payer's policy for non-Medicare claims.
Frequently asked questions
What is the difference between the Column 1 and Column 2 code?
In an NCCI Procedure-to-Procedure edit, the Column 1 code is the comprehensive (payable) code and the Column 2 code is the component code that is normally bundled into it. When both appear on the same claim for the same patient and date of service, Medicare pays the Column 1 code and denies the Column 2 code unless the edit's modifier indicator allows a bypass.
Which modifiers can bypass an NCCI edit?
Only edits with modifier indicator 1 can be bypassed. Depending on the pair, the bypass modifier is usually 59 or one of the more specific X modifiers (XE, XS, XP, XU) appended to the Column 2 code, or modifier 25 on a significant, separately identifiable E/M service. The clinical situation — separate site, separate encounter, distinct service — must be documented; indicator 0 edits accept no modifier at all.
Do commercial payers use NCCI edits?
Most large commercial payers and Medicaid programs base their bundling logic on NCCI, but many add proprietary edits on top. A clean NCCI result means Medicare would not bundle the pair under PTP edits; it is not a promise that every payer will pay both codes.