0016U
What 0016U is
This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.
Medically Unlikely Edit (MUE)
Medicare caps 0016U at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Analyte. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0016U? These codes are bundled into it
0016U is a Column 1 code in 139 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0009U | 1 - modifier may bypass | Check pair | |
0068U | 1 - modifier may bypass | Check pair | |
0086U | 1 - modifier may bypass | Check pair | |
0112U | 1 - modifier may bypass | Check pair | |
0115U | 1 - modifier may bypass | Check pair | |
0140U | 1 - modifier may bypass | Check pair | |
0141U | 1 - modifier may bypass | Check pair | |
0142U | 1 - modifier may bypass | Check pair | |
0202U | 1 - modifier may bypass | Check pair | |
0321U | 1 - modifier may bypass | Check pair | |
0330U | 1 - modifier may bypass | Check pair | |
80503 | Path clin consltj sf 5-20 | 1 - modifier may bypass | Check pair |
80504 | Path clin consltj mod 21-40 | 1 - modifier may bypass | Check pair |
80505 | Path clin consltj high 41-60 | 1 - modifier may bypass | Check pair |
80506 | Path clin consltj prolng svc | 1 - modifier may bypass | Check pair |
81206 | Bcr/abl1 gene major bp | 0 - no modifier bypass | Check pair |
81207 | Bcr/abl1 gene minor bp | 0 - no modifier bypass | Check pair |
81208 | Bcr/abl1 gene other bp | 0 - no modifier bypass | Check pair |
81513 | Nfct ds bv rna vag flu alg | 1 - modifier may bypass | Check pair |
84311 | Spectrophotometry | 1 - modifier may bypass | Check pair |
87140 | Culture type immunofluoresc | 1 - modifier may bypass | Check pair |
87143 | Culture typing glc/hplc | 1 - modifier may bypass | Check pair |
87147 | Culture type immunologic | 1 - modifier may bypass | Check pair |
87149 | Dna/rna direct probe | 1 - modifier may bypass | Check pair |
87150 | Dna/rna amplified probe | 1 - modifier may bypass | Check pair |
87152 | Culture type pulse field gel | 1 - modifier may bypass | Check pair |
87153 | Dna/rna sequencing | 1 - modifier may bypass | Check pair |
87154 | Cul typ id bld pthgn 6+ trgt | 1 - modifier may bypass | Check pair |
87158 | Culture typing added method | 1 - modifier may bypass | Check pair |
87468 | Anaplsma phgcytophlm amp prb | 1 - modifier may bypass | Check pair |
Showing 30 of 139 column 2 codes. Use the pair checker for any specific combination.
0016U is bundled into these codes
0016U appears as a Column 2 code in 121 active edits. Reported with one of these Column 1 codes on the same date of service, 0016U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0004M | 1 | Check pair | |
0006M | 1 | Check pair | |
0007M | 1 | Check pair | |
0026U | 1 | Check pair | |
0045U | 1 | Check pair | |
0047U | 1 | Check pair | |
0055U | 1 | Check pair | |
0060U | 1 | Check pair | |
0069U | 1 | Check pair | |
0087U | 1 | Check pair | |
0088U | 1 | Check pair | |
0089U | 1 | Check pair | |
0090U | 1 | Check pair | |
0101U | 1 | Check pair | |
0102U | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.