NCCI Bundling Checker

The National Correct Coding Initiative (NCCI) was created by CMS to prevent improper payment of procedure codes that should not be billed together. When two codes are "bundled," the lower-paying code is typically denied if both are billed on the same date of service.

Modifier indicator 0 means the codes should never be billed together. Indicator 1 means they can be billed together with an appropriate modifier (like modifier 59). Indicator 9 means the edit is not applicable.

Modifier 59 indicates that a procedure was distinct or independent from other services performed on the same day. It can sometimes allow bundled codes to be paid separately when the services were truly distinct.

If you believe services were truly distinct, gather documentation showing the medical necessity for separate procedures. Include operative notes, timing details, and anatomical locations. Our appeal template generator can help create a professional appeal letter.

CMS updates NCCI edits quarterly. Our database contains Q2 2026 edits with 2.72 million code pair combinations, including 1.77 million active edits.

If your codes are not bundled, they can generally be billed together without concern for NCCI edits. However, other coding rules (like MUE limits or LCD restrictions) may still apply.

Yes! If you suspect unbundling on your bill (being charged separately for procedures that should be combined), or if a claim was denied due to bundling, this tool helps you understand the relationship between procedure codes.

PTP stands for Procedure-to-Procedure. These edits define pairs of HCPCS/CPT codes that should not be reported together for the same beneficiary on the same date of service by the same provider.