0163U
What 0163U 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 0163U at 0 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: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0163U? These codes are bundled into it
0163U is a Column 1 code in 7 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 | |
|---|---|---|---|
0421U | 0 - no modifier bypass | Check pair | |
0501U | 0 - no modifier 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 |
81528 | Oncology colorectal scr | 0 - no modifier bypass | Check pair |
0163U is bundled into these codes
0163U appears as a Column 2 code in 8 active edits. Reported with one of these Column 1 codes on the same date of service, 0163U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0091U | 0 | Check pair | |
0414U | 1 | Check pair | |
0464U | 0 | Check pair | |
0499U | 1 | Check pair | |
G0104 | Ca screen;flexi sigmoidscope | 0 | Check pair |
G0105 | Colorectal scrn; hi risk ind | 0 | Check pair |
G0121 | Colon ca scrn not hi rsk ind | 0 | Check pair |
G0327 | Colon ca scrn;bld-bsd biomrk | 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.