0463U
What 0463U 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 0463U 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 0463U? These codes are bundled into it
0463U 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0502U | 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 |
81400 | Mopath procedure level 1 | 1 - modifier may bypass | Check pair |
81401 | Mopath procedure level 2 | 1 - modifier may bypass | Check pair |
81402 | Mopath procedure level 3 | 1 - modifier may bypass | Check pair |
81403 | Mopath procedure level 4 | 1 - modifier may bypass | Check pair |
81404 | Mopath procedure level 5 | 1 - modifier may bypass | Check pair |
81405 | Mopath procedure level 6 | 1 - modifier may bypass | Check pair |
81406 | Mopath procedure level 7 | 1 - modifier may bypass | Check pair |
81407 | Mopath procedure level 8 | 1 - modifier may bypass | Check pair |
81408 | Mopath procedure level 9 | 1 - modifier may bypass | Check pair |
87149 | Dna/rna direct probe | 1 - modifier may bypass | Check pair |
87150 | Dna/rna amplified probe | 1 - modifier may bypass | Check pair |
87153 | Dna/rna sequencing | 1 - modifier may bypass | Check pair |
87154 | Cul typ id bld pthgn 6+ trgt | 1 - modifier may bypass | Check pair |
87623 | Hpv low-risk types | 1 - modifier may bypass | Check pair |
87624 | Hpv hi-risk typ pooled rslt | 1 - modifier may bypass | Check pair |
87625 | Hpv types 16 & 18 only | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
G0452 | Molecular pathology interpr | 1 - modifier may bypass | Check pair |
G0476 | Hpv combo assay ca screen | 1 - modifier may bypass | Check pair |
0463U is bundled into these codes
0463U appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 0463U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0429U | 1 | Check pair | |
87253 | Virus inoculate tissue addl | 1 | Check pair |
87626 | Hpv sep hi-rsk typ&pool rslt | 0 | Check pair |
87800 | Detect agnt mult dna direc | 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.