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0452U

What 0452U 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 0452U 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 0452U? These codes are bundled into it

0452U is a Column 1 code in 25 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
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
81400Mopath procedure level 11 - modifier may bypassCheck pair
81401Mopath procedure level 21 - modifier may bypassCheck pair
81402Mopath procedure level 31 - modifier may bypassCheck pair
81403Mopath procedure level 41 - modifier may bypassCheck pair
81406Mopath procedure level 71 - modifier may bypassCheck pair
81408Mopath procedure level 91 - modifier may bypassCheck pair
84311Spectrophotometry1 - modifier may bypassCheck pair
88271Cytogenetics dna probe1 - modifier may bypassCheck pair
88272Cytogenetics 3-51 - modifier may bypassCheck pair
88273Cytogenetics 10-301 - modifier may bypassCheck pair
88274Cytogenetics 25-991 - modifier may bypassCheck pair
88275Cytogenetics 100-3001 - modifier may bypassCheck pair
88291Cyto/molecular report1 - modifier may bypassCheck pair
88365Insitu hybridization (fish)1 - modifier may bypassCheck pair
88366Insitu hybridization (fish)1 - modifier may bypassCheck pair
88367Insitu hybridization auto1 - modifier may bypassCheck pair
88368Insitu hybridization manual1 - modifier may bypassCheck pair
88374M/phmtrc alys ishquant/semiq1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
G0452Molecular pathology interpr1 - modifier may bypassCheck pair

0452U is bundled into these codes

0452U appears as a Column 2 code in 16 active edits. Reported with one of these Column 1 codes on the same date of service, 0452U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0012M1Check pair
0013M1Check pair
0235U1Check pair
0239U1Check pair
0242U1Check pair
0244U1Check pair
0326U1Check pair
0365U0Check pair
0420U1Check pair
0422U1Check pair
0467U0Check pair
0523U1Check pair
81404Mopath procedure level 51Check pair
81405Mopath procedure level 61Check pair
81407Mopath procedure level 81Check 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.