`0295U`

What 0295U 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 0295U 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 0295U? These codes are bundled into it

0295U is a Column 1 code in 18 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
`0067U`		0 - no modifier bypass	Check pair
`0249U`		0 - no modifier bypass	Check pair
`0418U`		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
`81519`	Oncology breast mrna	0 - no modifier bypass	Check pair
`81520`	Onc breast mrna 58 genes	0 - no modifier bypass	Check pair
`81521`	Onc breast mrna 70 genes	0 - no modifier bypass	Check pair
`81522`	Onc breast mrna 12 genes	0 - no modifier bypass	Check pair
`81523`	Onc brst mrna 70 cnt 31 gene	0 - no modifier bypass	Check pair
`88341`	Imhchem/imcytchm ea add antb	1 - modifier may bypass	Check pair
`88342`	Imhchem/imcytchm 1st antb	1 - modifier may bypass	Check pair
`88344`	Imhchem/imcytchm ea mlt antb	1 - modifier may bypass	Check pair
`88360`	Tumor immunohistochem/manual	1 - modifier may bypass	Check pair
`88361`	Tumor immunohistochem/comput	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair

0295U is bundled into these codes

0295U appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 0295U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0404U`		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.