0442U
What 0442U 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 0442U 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: Nature of Analyte. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0442U? These codes are bundled into it
0442U is a Column 1 code in 14 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 | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 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 |
86140 | C-reactive protein | 0 - no modifier bypass | Check pair |
86141 | C-reactive protein hs | 0 - no modifier bypass | Check pair |
87275 | Influenza b ag if | 1 - modifier may bypass | Check pair |
87276 | Influenza a ag if | 1 - modifier may bypass | Check pair |
87280 | Respiratory syncytial ag if | 1 - modifier may bypass | Check pair |
87420 | Resp syncytial virus ag ia | 1 - modifier may bypass | Check pair |
87633 | Resp virus 12-25 targets | 1 - modifier may bypass | Check pair |
87807 | Rsv assay w/optic | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
0442U is bundled into these codes
0442U appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 0442U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
87428 | Sarscov & inf vir a&b ag ia | 1 | Check pair |
87631 | Resp virus 3-5 targets | 1 | Check pair |
87632 | Resp virus 6-11 targets | 1 | Check pair |
87634 | Rsv dna/rna amp probe | 1 | Check pair |
87636 | Sarscov2 & inf a&b amp prb | 1 | Check pair |
87637 | Sarscov2&inf a&b&rsv amp prb | 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.