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0458U

What 0458U 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 0458U 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 0458U? These codes are bundled into it

0458U is a Column 1 code in 20 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
0009U0 - 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
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
88377M/phmtrc alys ishquant/semiq1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

0458U is bundled into these codes

0458U appears as a Column 2 code in 28 active edits. Reported with one of these Column 1 codes on the same date of service, 0458U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0036U1Check pair
0037U1Check pair
0045U1Check pair
0048U1Check pair
0239U1Check pair
0242U1Check pair
0244U1Check pair
0249U1Check pair
0250U1Check pair
0306U1Check pair
0307U1Check pair
0404U1Check pair
81415Exome sequence analysis1Check pair
81417Exome re-evaluation1Check pair
81425Genome sequence analysis1Check 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.