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.
For help with this tool, view the
NCCI PTP lookup help guide.