0405U
What 0405U 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 0405U at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0405U? These codes are bundled into it
0405U is a Column 1 code in 223 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 | |
|---|---|---|---|
0307U | 1 - modifier may bypass | Check pair | |
0318U | 1 - modifier may bypass | Check pair | |
0460U | 1 - modifier may bypass | Check pair | |
0461U | 1 - modifier may bypass | Check pair | |
0510U | 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 |
81105 | Hpa-1 genotyping | 1 - modifier may bypass | Check pair |
81106 | Hpa-2 genotyping | 1 - modifier may bypass | Check pair |
81107 | Hpa-3 genotyping | 1 - modifier may bypass | Check pair |
81108 | Hpa-4 genotyping | 1 - modifier may bypass | Check pair |
81109 | Hpa-5 genotyping | 1 - modifier may bypass | Check pair |
81110 | Hpa-6 genotyping | 1 - modifier may bypass | Check pair |
81111 | Hpa-9 genotyping | 1 - modifier may bypass | Check pair |
81112 | Hpa-15 genotyping | 1 - modifier may bypass | Check pair |
81120 | Idh1 common variants | 1 - modifier may bypass | Check pair |
81121 | Idh2 common variants | 1 - modifier may bypass | Check pair |
81161 | Dmd dup/delet analysis | 1 - modifier may bypass | Check pair |
81168 | Ccnd1/igh translocation alys | 1 - modifier may bypass | Check pair |
81170 | Abl1 gene | 1 - modifier may bypass | Check pair |
81171 | Aff2 gen aly detc abnl allel | 1 - modifier may bypass | Check pair |
81172 | Aff2 gen alys charac alleles | 1 - modifier may bypass | Check pair |
81173 | Ar gene full gene sequence | 1 - modifier may bypass | Check pair |
81174 | Ar gene known famil variant | 1 - modifier may bypass | Check pair |
81175 | Asxl1 full gene sequence | 1 - modifier may bypass | Check pair |
81176 | Asxl1 gene target seq alys | 1 - modifier may bypass | Check pair |
81177 | Atn1 gene detc abnor alleles | 1 - modifier may bypass | Check pair |
81178 | Atxn1 gene detc abnor allele | 1 - modifier may bypass | Check pair |
81179 | Atxn2 gene detc abnor allele | 1 - modifier may bypass | Check pair |
Showing 30 of 223 column 2 codes. Use the pair checker for any specific combination.
0405U is bundled into these codes
0405U appears as a Column 2 code in 22 active edits. Reported with one of these Column 1 codes on the same date of service, 0405U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0239U | 1 | Check pair | |
0242U | 1 | Check pair | |
0244U | 1 | Check pair | |
0306U | 1 | Check pair | |
0326U | 1 | Check pair | |
0336U | 1 | Check pair | |
0340U | 1 | Check pair | |
0410U | 1 | Check pair | |
0474U | 1 | Check pair | |
81349 | Cytog alys chrml abnr lw-ps | 1 | Check pair |
81415 | Exome sequence analysis | 1 | Check pair |
81417 | Exome re-evaluation | 1 | Check pair |
81425 | Genome sequence analysis | 1 | Check pair |
81427 | Genome re-evaluation | 1 | Check pair |
81443 | Genetic tstg severe inh cond | 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.