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0513U

What 0513U 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 0513U 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 0513U? These codes are bundled into it

0513U is a Column 1 code in 30 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
0169U1 - modifier may bypassCheck pair
0228U0 - no modifier bypassCheck pair
0286U1 - 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
81313Pca3/klk3 antigen1 - modifier may bypassCheck pair
81400Mopath procedure level 11 - modifier may bypassCheck pair
81401Mopath procedure level 21 - modifier may bypassCheck pair
81402Mopath procedure level 31 - modifier may bypassCheck pair
81403Mopath procedure level 41 - modifier may bypassCheck pair
81404Mopath procedure level 51 - modifier may bypassCheck pair
81405Mopath procedure level 61 - modifier may bypassCheck pair
81406Mopath procedure level 71 - 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
84311Spectrophotometry1 - modifier may bypassCheck pair
88271Cytogenetics dna probe1 - modifier may bypassCheck pair
88272Cytogenetics 3-51 - modifier may bypassCheck pair
88273Cytogenetics 10-301 - modifier may bypassCheck pair
88274Cytogenetics 25-991 - modifier may bypassCheck pair
88275Cytogenetics 100-3001 - modifier may bypassCheck pair
88291Cyto/molecular report1 - modifier may bypassCheck pair
88365Insitu hybridization (fish)1 - modifier may bypassCheck pair
88366Insitu hybridization (fish)1 - modifier may bypassCheck pair
88367Insitu hybridization auto1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
G0452Molecular pathology interpr1 - modifier may bypassCheck pair

0513U is bundled into these codes

0513U appears as a Column 2 code in 25 active edits. Reported with one of these Column 1 codes on the same date of service, 0513U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0005U0Check pair
0011M0Check pair
0021U0Check pair
0047U1Check pair
0113U1Check pair
0239U1Check pair
0242U1Check pair
0244U1Check pair
0339U0Check pair
0340U1Check pair
0343U0Check pair
0359U0Check pair
0403U0Check pair
0433U0Check pair
0475U0Check 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.