0225U
What 0225U 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 0225U 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: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0225U? These codes are bundled into it
0225U is a Column 1 code in 40 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 | |
|---|---|---|---|
0115U | 0 - no modifier bypass | Check pair | |
0202U | 0 - no modifier bypass | Check pair | |
0223U | 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 |
87260 | Adenovirus ag if | 0 - no modifier bypass | Check pair |
87267 | Enterovirus antibody dfa | 0 - no modifier bypass | Check pair |
87275 | Influenza b ag if | 0 - no modifier bypass | Check pair |
87276 | Influenza a ag if | 0 - no modifier bypass | Check pair |
87279 | Parainfluenza ag if | 0 - no modifier bypass | Check pair |
87280 | Respiratory syncytial ag if | 0 - no modifier bypass | Check pair |
87301 | Adenovirus ag ia | 0 - no modifier bypass | Check pair |
87400 | Influenza a/b each ag ia | 0 - no modifier bypass | Check pair |
87420 | Resp syncytial virus ag ia | 0 - no modifier bypass | Check pair |
87426 | Sarscov coronavirus ag ia | 0 - no modifier bypass | Check pair |
87483 | Cns dna amp probe type 12-25 | 1 - modifier may bypass | Check pair |
87485 | Chlmyd pneum dna dir probe | 0 - no modifier bypass | Check pair |
87486 | Chlmyd pneum dna amp probe | 0 - no modifier bypass | Check pair |
87487 | Chlmyd pneum dna quant | 0 - no modifier bypass | Check pair |
87498 | Enterovirus probe&revrs trns | 0 - no modifier bypass | Check pair |
87501 | Influenza dna amp prob 1+ | 0 - no modifier bypass | Check pair |
87502 | Influenza dna amp probe | 0 - no modifier bypass | Check pair |
87503 | Influenza dna amp prob addl | 0 - no modifier bypass | Check pair |
87580 | M.pneumon dna dir probe | 0 - no modifier bypass | Check pair |
87581 | M.pneumon dna amp probe | 0 - no modifier bypass | Check pair |
87582 | M.pneumon dna quant | 0 - no modifier bypass | Check pair |
87631 | Resp virus 3-5 targets | 0 - no modifier bypass | Check pair |
87632 | Resp virus 6-11 targets | 0 - no modifier bypass | Check pair |
Showing 30 of 40 column 2 codes. Use the pair checker for any specific combination.
0225U is bundled into these codes
0225U appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 0225U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0480U | 1 | Check pair | |
0528U | 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.