0499U
What 0499U 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 0499U 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 0499U? These codes are bundled into it
0499U is a Column 1 code in 61 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 | |
|---|---|---|---|
0091U | 1 - modifier may bypass | Check pair | |
0163U | 1 - modifier may bypass | Check pair | |
0238U | 1 - modifier may bypass | Check pair | |
0421U | 1 - modifier may bypass | Check pair | |
0453U | 1 - modifier may bypass | Check pair | |
0464U | 1 - modifier may bypass | Check pair | |
0478U | 1 - modifier may bypass | Check pair | |
0501U | 1 - modifier may 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 |
81202 | Apc gene known fam variants | 1 - modifier may bypass | Check pair |
81203 | Apc gene dup/delet variants | 1 - modifier may bypass | Check pair |
81210 | Braf gene | 0 - no modifier bypass | Check pair |
81235 | Egfr gene com variants | 1 - modifier may bypass | Check pair |
81275 | Kras gene variants exon 2 | 0 - no modifier bypass | Check pair |
81276 | Kras gene addl variants | 0 - no modifier bypass | Check pair |
81288 | Mlh1 gene | 1 - modifier may bypass | Check pair |
81293 | Mlh1 gene known variants | 1 - modifier may bypass | Check pair |
81294 | Mlh1 gene dup/delete variant | 1 - modifier may bypass | Check pair |
81295 | Msh2 gene full seq | 1 - modifier may bypass | Check pair |
81296 | Msh2 gene known variants | 1 - modifier may bypass | Check pair |
81297 | Msh2 gene dup/delete variant | 1 - modifier may bypass | Check pair |
81299 | Msh6 gene known variants | 1 - modifier may bypass | Check pair |
81300 | Msh6 gene dup/delete variant | 1 - modifier may bypass | Check pair |
81301 | Microsatellite instability | 1 - modifier may bypass | Check pair |
81309 | Pik3ca gene trgt seq alys | 1 - modifier may bypass | Check pair |
81318 | Pms2 known familial variants | 1 - modifier may bypass | Check pair |
Showing 30 of 61 column 2 codes. Use the pair checker for any specific combination.
0499U is bundled into these codes
0499U appears as a Column 2 code in 40 active edits. Reported with one of these Column 1 codes on the same date of service, 0499U is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0101U | 1 | Check pair | |
0111U | 0 | Check pair | |
0179U | 1 | Check pair | |
0239U | 1 | Check pair | |
0242U | 1 | Check pair | |
0244U | 1 | Check pair | |
0261U | 1 | Check pair | |
0317U | 1 | Check pair | |
0326U | 1 | Check pair | |
0340U | 1 | Check pair | |
0414U | 1 | Check pair | |
0498U | 1 | Check pair | |
0523U | 1 | Check pair | |
0530U | 1 | Check pair | |
0537U | 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.