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0434U

What 0434U is

This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.

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Medically Unlikely Edit (MUE)

Medicare caps 0434U 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 0434U? These codes are bundled into it

0434U is a Column 1 code in 331 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 codeShort descriptionModifier indicator
0030U0 - no modifier bypassCheck pair
0034U0 - no modifier bypassCheck pair
0070U0 - no modifier bypassCheck pair
0169U0 - no modifier bypassCheck pair
0173U1 - modifier may bypassCheck pair
0175U1 - modifier may bypassCheck pair
0392U0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
80503Path clin consltj sf 5-201 - modifier may bypassCheck pair
80504Path clin consltj mod 21-401 - modifier may bypassCheck pair
80505Path clin consltj high 41-601 - modifier may bypassCheck pair
81105Hpa-1 genotyping1 - modifier may bypassCheck pair
81106Hpa-2 genotyping1 - modifier may bypassCheck pair
81107Hpa-3 genotyping1 - modifier may bypassCheck pair
81108Hpa-4 genotyping1 - modifier may bypassCheck pair
81109Hpa-5 genotyping1 - modifier may bypassCheck pair
81110Hpa-6 genotyping1 - modifier may bypassCheck pair
81111Hpa-9 genotyping1 - modifier may bypassCheck pair
81112Hpa-15 genotyping1 - modifier may bypassCheck pair
81120Idh1 common variants1 - modifier may bypassCheck pair
81121Idh2 common variants1 - modifier may bypassCheck pair
81161Dmd dup/delet analysis1 - modifier may bypassCheck pair
81162Brca1&2 gen full seq dup/del1 - modifier may bypassCheck pair
81163Brca1&2 gene full seq alys1 - modifier may bypassCheck pair
81164Brca1&2 gen ful dup/del alys1 - modifier may bypassCheck pair
81165Brca1 gene full seq alys1 - modifier may bypassCheck pair
81166Brca1 gene full dup/del alys1 - modifier may bypassCheck pair
81167Brca2 gene full dup/del alys1 - modifier may bypassCheck pair
81168Ccnd1/igh translocation alys1 - modifier may bypassCheck pair

Showing 30 of 331 column 2 codes. Use the pair checker for any specific combination.

0434U is bundled into these codes

0434U appears as a Column 2 code in 40 active edits. Reported with one of these Column 1 codes on the same date of service, 0434U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0347U0Check pair
0348U0Check pair
0349U0Check pair
0350U0Check pair
81228Cytog alys chrml abnr cgh1Check pair
81229Cytog alys chrml abnr snpcgh1Check pair
81410Aortic dysfunction/dilation1Check pair
81411Aortic dysfunction/dilation1Check pair
81412Ashkenazi jewish assoc dis1Check pair
81413Car ion chnnlpath inc 10 gns1Check pair
81414Car ion chnnlpath inc 2 gns1Check pair
81415Exome sequence analysis1Check pair
81417Exome re-evaluation1Check pair
81420Fetal chrmoml aneuploidy1Check pair
81422Fetal chrmoml microdeltj1Check 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.