A CMS Medicare Administrative Contractor
The National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) lookup tool is designed to help providers identify when certain codes are subject to the automated code pair edits. Search for coding pairs by entering a procedure code and the performing date(s) of service. The search results display two coding pair lists; refer to the Major-to-Minor and the Minor-to-Major tabs.
When two codes of an edit pair are identified, the major/column 1 code is eligible for payment and the minor/column 2 code is denied with claim adjustment reason code (CARC) CO236. However, both codes may be eligible for payment when the modifier/policy indicator 1 (allowed) is present and an appropriate modifier is appended to the minor/column 2 code on the claim.