Double-Charge Detector 0474U

Hered pan ca gsap 88gene ngs — 146 bundling rules

If your bill lists 0474U alongside any of these codes as separate charges, it may be an unbundling error.

By David Park , Healthcare Cost Researcher · Published March 15, 2026 · Updated April 3, 2026

About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

NCCI edit data

146 code pairs

Updated 2026-04-03

Bundling rules — 0474U

NCCI edits: these codes have billing restrictions when billed with 0474U

Research suggests 49–80% of hospital bills contain errors. Our system checks every line item against Medicare benchmarks.

Common unbundling errors — medical procedures

Unbundling occurs when medical providers bill two separate codes for services that should be combined into a single charge according to National Correct Coding Initiative (NCCI) rules. In other procedures including anesthesia, radiology, pathology, and miscellaneous support services, common unbundling patterns include separately billing diagnostic imaging with its professional interpretation when both should be included in one comprehensive code, and charging for basic monitoring or preparation services alongside the primary procedure when these components are considered integral parts of the main service. Another frequent error involves billing multiple pathology examination codes for what constitutes a single comprehensive analysis. With 809 other codes subject to bundling restrictions in the NCCI database, these errors create charges above the benchmark for patients who receive multiple bills for what should constitute one complete service. The potential difference between unbundled billing and correct coding practices can significantly impact patient financial responsibility, as they may face duplicate charges for components of care that medical coding standards define as a single billable service.

What to check on your bill

When reviewing itemized bills for procedure bundling issues, patients should examine several key areas to identify potential billing irregularities. Look for multiple procedure codes billed on the same date that represent components of a comprehensive service, such as separate charges for incision, repair, and closure when these steps are typically included in one primary procedure code. Watch for code patterns where related procedures share the same first three digits, as these often indicate services that should be bundled together under Medicare's Correct Coding Initiative. Check for appropriate modifier usage, particularly modifier 59 or XS, which legitimately allow separate billing when procedures are performed on different anatomical sites or during distinct sessions. Without proper modifiers, separately billed related procedures may represent charges above the benchmark. Compare your itemized statement against standard bundling practices for your specific procedure type to identify potential differences in billing patterns.

All bundling rules for 0474U

146 code pairs that have billing restrictions with this procedure.

Never bill together

May bill with modifier

Code	Description	Rule
0009U	Onc brst ca erbb2 amp/nonamp	May bill with modifier
0016U	Onc hmtlmf neo rna bcr/abl1	May bill with modifier
0017U	Onc hmtlmf neo jak2 mut dna	May bill with modifier
0048U	Onc sld org neo dna 468 gene	Never bill together
0069U	Onc clrct microrna mir-31-3p	May bill with modifier
0089U	Onc mlnma prame & linc00518	Never bill together
0091U	0091U	Never bill together
0111U	Onc colon ca kras&nras alys	May bill with modifier
0129U	Hered brst ca rltd do panel	Never bill together
0155U	Onc brst ca dna pik3ca gene	May bill with modifier
0177U	Onc brst ca dna pik3ca 11	May bill with modifier
0228U	Onc prst8 ma molec prfl alg	May bill with modifier
0229U	Bcat1&ikzf1 prmtr mthyln aly	May bill with modifier
0235U	Pten full gene analysis	Never bill together
0314U	Onc cutan mlnma mrna 35 gene	Never bill together
0343U	Onc prst8 xom aly 442 sncrna	May bill with modifier
0359U	Onc prst8 ca alys all psa	May bill with modifier
0368U	Onc clrct ca mut&mthyltn mrk	Never bill together
0403U	Onc prst8 mrna 18 gen 1st ur	May bill with modifier
0405U	Onc pncrtc 59 mthltn blk mrk	May bill with modifier
0406U	Onc lung flow cytmtry 5 mrk	May bill with modifier
0410U	Onc pncrtc dna whl gn seq 5-	May bill with modifier
0421U	Onc clrct scr sgl amp 8 rna	Never bill together
0422U	Onc pan solid tum alys dna	May bill with modifier
0424U	Onc prst8 xom alys 53 sncrna	May bill with modifier
0433U	Onc prst8 5 dna reg mrk pcr	May bill with modifier
0453U	Onc clrct ca cfdna qpcr asy	Never bill together
0471U	Onc clrc ca 35 vrn kras&nras	May bill with modifier
0475U	Hered prst8 ca gsap 23 genes	Never bill together
0501U	Onc clrc bld quan meas cfdna	Never bill together
36591	Draw blood off venous device	Never bill together
36592	Collect blood from picc	Never bill together
80503	Path clin consltj sf 5-20	May bill with modifier
80504	Path clin consltj mod 21-40	May bill with modifier
80505	Path clin consltj high 41-60	May bill with modifier
81120	Idh1 common variants	May bill with modifier
81121	Idh2 common variants	May bill with modifier
81163	Brca1&2 gene full seq alys	Never bill together
81164	Brca1&2 gen ful dup/del alys	Never bill together
81165	Brca1 gene full seq alys	Never bill together
81166	Brca1 gene full dup/del alys	Never bill together
81167	Brca2 gene full dup/del alys	Never bill together
81168	Ccnd1/igh translocation alys	May bill with modifier
81175	Asxl1 full gene sequence	May bill with modifier
81176	Asxl1 gene target seq alys	May bill with modifier
81201	Apc gene full sequence	Never bill together
81202	Apc gene known fam variants	Never bill together
81203	Apc gene dup/delet variants	Never bill together
81206	Bcr/abl1 gene major bp	May bill with modifier
81207	Bcr/abl1 gene minor bp	May bill with modifier

Showing 50 of 146 rules. Show all

FAQ — medical procedure bundling

What is NCCI bundling and what does 'bundled' mean on a medical bill?

NCCI bundling refers to the National Correct Coding Initiative rules that prevent certain procedure codes from being billed separately when performed together. When codes are bundled, one procedure is considered inclusive of another, meaning only the primary procedure should be billed rather than charging for each component separately.

How can I identify if codes were incorrectly unbundled on my bill?

Incorrectly unbundled codes appear as separate line items on your bill when NCCI rules indicate they should be grouped together under one primary procedure code. This typically occurs with anesthesia, radiology, pathology, and miscellaneous support services that are considered integral to the main procedure being performed.

What should I do if I find unbundled charges on my medical bill?

Contact your healthcare provider's billing department to request a review of the charges and provide documentation showing the NCCI bundling rules that apply. Request an itemized explanation of why the codes were billed separately and ask for a corrected bill that reflects proper bundling if no valid modifier justification exists.

When is it legitimate to use modifiers to override NCCI bundling rules?

Modifiers are appropriately used when procedures are performed on different anatomical sites, during separate patient encounters, or when distinct procedural services are provided that don't fall under the bundling restrictions. The modifier usage must be supported by clear documentation in the medical record that demonstrates the services were truly separate and distinct from the bundled procedure.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

Data source: CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits, updated quarterly. These code pairs are maintained by CMS to prevent improper billing of services that should be billed as a single procedure.

What this means: When two codes are listed as an NCCI edit pair, billing them separately on the same date of service is typically incorrect. "Never bill together" means no modifier can override the rule. "May bill with modifier" means the codes can be billed separately with appropriate documentation.