0064U
What 0064U 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 0064U at 2 units 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 0064U? These codes are bundled into it
0064U is a Column 1 code in 16 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 | |
|---|---|---|---|
0065U | 0 - no modifier bypass | Check pair | |
0210U | 0 - no modifier bypass | Check pair | |
0251U | 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 |
83516 | Immunoassay nonantibody | 1 - modifier may bypass | Check pair |
83518 | Immunoassay dipstick | 1 - modifier may bypass | Check pair |
83519 | Ria nonantibody | 1 - modifier may bypass | Check pair |
83520 | Immunoassay quant nos nonab | 1 - modifier may bypass | Check pair |
86592 | Syphilis test non-trep qual | 0 - no modifier bypass | Check pair |
86593 | Syphilis test non-trep quant | 0 - no modifier bypass | Check pair |
86780 | Treponema pallidum | 1 - modifier may bypass | Check pair |
87285 | Treponema pallidum ag if | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
0064U is bundled into these codes
0064U appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 0064U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
80081 | Obstetric panel inc hiv tstg | 0 | 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.