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0471U

What 0471U 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 0471U 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 0471U? These codes are bundled into it

0471U is a Column 1 code in 49 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
0111U1 - modifier may bypassCheck pair
0238U1 - modifier may bypassCheck pair
0453U1 - modifier may 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
81201Apc gene full sequence1 - modifier may bypassCheck pair
81202Apc gene known fam variants1 - modifier may bypassCheck pair
81203Apc gene dup/delet variants1 - modifier may bypassCheck pair
81275Kras gene variants exon 21 - modifier may bypassCheck pair
81276Kras gene addl variants1 - modifier may bypassCheck pair
81288Mlh1 gene1 - modifier may bypassCheck pair
81292Mlh1 gene full seq1 - modifier may bypassCheck pair
81293Mlh1 gene known variants1 - modifier may bypassCheck pair
81294Mlh1 gene dup/delete variant1 - modifier may bypassCheck pair
81295Msh2 gene full seq1 - modifier may bypassCheck pair
81296Msh2 gene known variants1 - modifier may bypassCheck pair
81297Msh2 gene dup/delete variant1 - modifier may bypassCheck pair
81298Msh6 gene full seq1 - modifier may bypassCheck pair
81299Msh6 gene known variants1 - modifier may bypassCheck pair
81300Msh6 gene dup/delete variant1 - modifier may bypassCheck pair
81311Nras gene variants exon 2&31 - modifier may bypassCheck pair
81317Pms2 gene full seq analysis1 - modifier may bypassCheck pair
81318Pms2 known familial variants1 - modifier may bypassCheck pair
81319Pms2 gene dup/delet variants1 - modifier may bypassCheck pair
81445So neo gsap 5-50dna/dna&rna1 - modifier may bypassCheck pair
81449So neo gsap 5-50 rna alys1 - modifier may bypassCheck pair
81455So/hl 51/>gsap dna/dna&rna1 - modifier may bypassCheck pair

Showing 30 of 49 column 2 codes. Use the pair checker for any specific combination.

0471U is bundled into these codes

0471U appears as a Column 2 code in 27 active edits. Reported with one of these Column 1 codes on the same date of service, 0471U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0036U1Check pair
0037U1Check pair
0048U1Check pair
0069U1Check pair
0101U1Check pair
0211U1Check pair
0239U1Check pair
0242U1Check pair
0244U1Check pair
0250U1Check pair
0297U1Check pair
0298U1Check pair
0300U1Check pair
0306U1Check pair
0307U1Check 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.