Billable Code Groups

CMS National Correct Coding Initiative, practitioner PTP edits, 2026 Q2

Signed off v1

Read by bundling_edit. Those nodes reach this table through table_lookup on code. A key that is not in the table is a no_match — the lookup fails closed on that node and the walk continues. It is not on_field_missing, which means something different: that the claim did not carry the field.

bcg

16 of 16 rows

code	group	billable	bundled into	note
20610	—	True	—	Stands alone; no procedure-to-procedure pair applies.
29881	—	True	—	Stands alone; no procedure-to-procedure pair applies.
70553	—	True	—	Stands alone; no procedure-to-procedure pair applies.
72148	—	True	—	Stands alone; no procedure-to-procedure pair applies.
80053	Comprehensive metabolic panel	True	—	Stands alone; no procedure-to-procedure pair applies.
82947	Comprehensive metabolic panel	False	80053	A component of 80053. Payable alone only if 80053 was not billed for the same member on the same date.
85025	Complete blood count	True	—	Stands alone; no procedure-to-procedure pair applies.
90837	—	True	—	Stands alone; no procedure-to-procedure pair applies.
93000	—	True	—	Stands alone; no procedure-to-procedure pair applies.
99213	—	True	—	Stands alone; no procedure-to-procedure pair applies.
99214	—	True	—	Stands alone; no procedure-to-procedure pair applies.
99215	—	True	—	Stands alone; no procedure-to-procedure pair applies.
99212	—	True	—	Stands alone; no procedure-to-procedure pair applies.
J9299	—	True	—	Stands alone; no procedure-to-procedure pair applies.
J9355	—	True	—	Stands alone; no procedure-to-procedure pair applies.
84075	Comprehensive metabolic panel	False	80053	A component of 80053. Present so the table covers the panel, not only the codes this batch happens to bill.

Versions

Signed-off wins, else the highest. 1 on disk.

v1 · bcg.v1.yaml 16 rows · CMS National Correct Coding Initiative, practitioner PTP edits, 2026 Q2 Active signed 2026-02-01