Check Code Pair
check_code_pairCan two procedure codes be billed together on the same day? Checks the CMS National Correct Coding Initiative procedure-to-procedure (PTP) edit for a pair of HCPCS/CPT codes and returns the modifier indicator saying whether the pair can never be unbundled, can be unbundled with an appropriate modifier and documentation, or carries no edit in the loaded data. Answers "can I bill 99214 and 93000 together", "is there an NCCI edit between these two codes", "do I need a modifier for this code combination". Built from CMS's FULL NCCI PTP edit baseline (2026q3, v322r0), not just a rolling change window — a pair not found here has never had a CMS-recorded PTP edit as of the loaded vintage. The response always states the loaded vintage and setting resolved.
Input Schema
| Name | Required | Description | Default |
|---|---|---|---|
| code_a | Yes | First HCPCS/CPT code, e.g. "99214". | |
| code_b | Yes | Second HCPCS/CPT code, e.g. "93000". | |
| setting | No | Which edit table: "practitioner" (default) or "hospital" (outpatient facility). Edits can differ between them. |