0478U
What 0478U 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 0478U at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0478U? These codes are bundled into it
0478U is a Column 1 code in 42 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 | |
|---|---|---|---|
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 |
81191 | Ntrk1 translocation analysis | 1 - modifier may bypass | Check pair |
81192 | Ntrk2 translocation analysis | 1 - modifier may bypass | Check pair |
81193 | Ntrk3 translocation analysis | 1 - modifier may bypass | Check pair |
81194 | Ntrk translocation analysis | 1 - modifier may bypass | Check pair |
81232 | Dpyd gene common variants | 1 - modifier may bypass | Check pair |
81235 | Egfr gene com variants | 1 - modifier may bypass | Check pair |
81275 | Kras gene variants exon 2 | 1 - modifier may bypass | Check pair |
81276 | Kras gene addl variants | 1 - modifier may bypass | Check pair |
81346 | Tyms gene com variants | 1 - modifier may bypass | Check pair |
81352 | Tp53 gene trgt sequence alys | 1 - modifier may bypass | Check pair |
81353 | Tp53 gene known famil vrnt | 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 |
81417 | Exome re-evaluation | 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 |
Showing 30 of 42 column 2 codes. Use the pair checker for any specific combination.
0478U is bundled into these codes
0478U appears as a Column 2 code in 23 active edits. Reported with one of these Column 1 codes on the same date of service, 0478U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0022U | 1 | Check pair | |
0080U | 0 | Check pair | |
0092U | 0 | Check pair | |
0179U | 1 | Check pair | |
0239U | 1 | Check pair | |
0242U | 1 | Check pair | |
0288U | 1 | Check pair | |
0317U | 0 | Check pair | |
0360U | 1 | Check pair | |
0388U | 1 | Check pair | |
0395U | 1 | Check pair | |
0406U | 0 | Check pair | |
0414U | 1 | Check pair | |
0499U | 1 | Check pair | |
0523U | 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.