0458U
What 0458U 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 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0009U | 0 - no modifier bypass | Check pair | |
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 |
84311 | Spectrophotometry | 1 - modifier may bypass | Check pair |
88271 | Cytogenetics dna probe | 1 - modifier may bypass | Check pair |
88272 | Cytogenetics 3-5 | 1 - modifier may bypass | Check pair |
88273 | Cytogenetics 10-30 | 1 - modifier may bypass | Check pair |
88274 | Cytogenetics 25-99 | 1 - modifier may bypass | Check pair |
88275 | Cytogenetics 100-300 | 1 - modifier may bypass | Check pair |
88291 | Cyto/molecular report | 1 - modifier may bypass | Check pair |
88365 | Insitu hybridization (fish) | 1 - modifier may bypass | Check pair |
88366 | Insitu hybridization (fish) | 1 - modifier may bypass | Check pair |
88367 | Insitu hybridization auto | 1 - modifier may bypass | Check pair |
88368 | Insitu hybridization manual | 1 - modifier may bypass | Check pair |
88374 | M/phmtrc alys ishquant/semiq | 1 - modifier may bypass | Check pair |
88377 | M/phmtrc alys ishquant/semiq | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0036U | 1 | Check pair | |
0037U | 1 | Check pair | |
0045U | 1 | Check pair | |
0048U | 1 | Check pair | |
0239U | 1 | Check pair | |
0242U | 1 | Check pair | |
0244U | 1 | Check pair | |
0249U | 1 | Check pair | |
0250U | 1 | Check pair | |
0306U | 1 | Check pair | |
0307U | 1 | Check pair | |
0404U | 1 | Check pair | |
81415 | Exome sequence analysis | 1 | Check pair |
81417 | Exome re-evaluation | 1 | Check pair |
81425 | Genome sequence analysis | 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.