CodeCloud Nova - Medical Coding Intelligence

Range Guidelines

« Code Details »

All Details

Crosswalk

Code	Description
No Crosswalks Found

NCCI

Pair	Reason	Mod
No Edits Found

Fee Schedule

Component	RVU	Amount
No Fee Schedule Found

Global Period	Pre-Op %	Intra-Op %	Post-Op %
--	0	0	0

LCD Reference

LCD ID	Contractor	LCD Description
No LCDs Found

Code	Description

Code	Drug

Title

NCCI Validation - Non-Facility (Practitioner PTP Edits, v32.1)

Paste the CPT/HCPCS codes that appeared on the same encounter. Pairs that hit an active CMS Procedure-to-Procedure edit will be listed below.

As of date

Column 1	Column 2	Modifier Indicator	Rationale	Effective Dates
Enter codes above and click Validate.

NCCI Validation - Facility (Hospital/Outpatient PTP Edits, v3.21)

Paste the CPT/HCPCS codes that appeared on the same hospital outpatient encounter. Pairs that hit an active CMS Hospital OCE Procedure-to-Procedure edit will be listed below.

As of date

Column 1	Column 2	Modifier Indicator	Rationale	Effective Dates
Enter codes above and click Validate.

UB-04 Revenue Code Lookup (Pub.100-04 Ch.7 Section 60.1)

Paste HCPCS codes to see which UB-04 Revenue Code and Bill Type each should appear under for SNF institutional billing. Rules per CMS Medicare Claims Processing Manual, Ch.7 Section 60.1.

0274 Prosthetics & Orthotics (L-codes) 0623 Surgical Dressings (A6000-series) 0270 General Supplies (Outpatient)

HCPCS	Description	Revenue Code	Category	Bill Type(s)
Enter HCPCS codes above and click Look Up.

Complete UB-04 Revenue Code Reference (NUBC)

Browse the full NUBC Revenue Code catalog (FL 42 on UB-04). Codes ending in X are category headers; numeric codes are line-level. Filter by keyword or category.

Code	Category	Description
Loading...

MPFS Fee Schedule (CY 2026 - Conversion Factor $33.4009)

Enter CPT/HCPCS codes and select a Medicare locality. Allowed = [(Work RVU x GPCI_W) + (PE RVU x GPCI_PE) + (MP RVU x GPCI_MP)] x CF.

Locality

Code	Work RVU	PE RVU (NF / Fac)	MP RVU	Allowed (Non-Facility)	Allowed (Facility)	Global	Description
Enter codes, pick a locality, and click Compute.

CPT/HCPCS Crosswalks - Deletion & Replacement Lookup

Look up a HCPCS Level II code to see when it was added, whether it has been deleted, and its CMS-published replacement (CROSS_REF_CODE). True CPT-Cat-I ↔ HCPCS-II crosswalks are AMA-owned and not redistributed here.

Termination year

Code	Long Description	Termination Date	Replacement	Replacement Description
Pick a year and click Show Deleted Codes.

HCPCS - NDC Crosswalk (ASP, Q2 2026)

Enter a 5-character HCPCS code (e.g. J9035) to see all NDCs that bill under it, or an 11-digit NDC (with or without hyphens, e.g. 50242-0060-01) to find the HCPCS billing code. ASP payment limit shown when available.

HCPCS	NDC	Drug Name	Labeler	Package Size	Billing Units
Enter a HCPCS code or NDC above and click Look Up.

ABN Form (CMS-R-131) - Fill In

A. Notifier Name Address City/State/ZIP Phone

B. Patient Patient Name C. Identification Number

Items / Services (up to 5)

D. Description	E. Reason Medicare May Not Pay	F. Est. Cost ($)

G. Options (printed; patient picks at signing) Leave blank (patient selects) Pre-mark Option 1 Pre-mark Option 2 Pre-mark Option 3

H. Additional Information

Tip: in the print dialog, choose "Save as PDF" as the destination.

Advance Beneficiary Notice of Noncoverage (ABN)

NOTE: If Medicare doesn't pay for D. below, you may have to pay.

Medicare does not pay for everything, even some care that you or your health care provider have good reason to think you need. We expect Medicare may not pay for D. below.

Form CMS-R-131 (Exp. 01/31/2026)

Form Approved OMB No. 0938-0566

A. Notifier:

B. Patient Name:
C. Identification Number:

D. Items / Services	E. Reason Medicare May Not Pay:	F. Estimated Cost

G. OPTIONS: Check only one box. We cannot choose a box for you.

☐ OPTION 1. I want the D. listed above. You may ask to be paid now, but I also want Medicare billed for an official decision on payment, which is sent to me on a Medicare Summary Notice (MSN). I understand that if Medicare doesn't pay, I am responsible for payment, but I can appeal to Medicare by following the directions on the MSN. If Medicare does pay, you will refund any payments I made to you, less co-pays or deductibles.

☐ OPTION 2. I want the D. listed above, but do not bill Medicare. You may ask to be paid now as I am responsible for payment. I cannot appeal if Medicare is not billed.

☐ OPTION 3. I don't want the D. listed above. I understand with this choice I am not responsible for payment, and I cannot appeal to see if Medicare would pay.

H. Additional Information:

This notice gives our opinion, not an official Medicare decision. If you have other questions on this notice or Medicare billing, call 1-800-MEDICARE (1-800-633-4227 / TTY: 1-877-486-2048).

Signing below means that you have received and understand this notice. You also receive a copy.

I. Signature: ____________________________

J. Date: ____________________

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-0566. The time required to complete this information collection is estimated to average 7 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.
Form CMS-R-131 (Exp. 01/31/2026) Form Approved OMB No. 0938-0566

How to choose: Total Time vs Medical Decision Making (MDM) ▸

Per the 2021 (office) and 2023 (hospital, ED, NF, home) AMA E&M revisions you may select the visit level by either total practitioner time on the encounter date or by MDM. History & exam are no longer scoring elements.

Authoritative source: CMS MLN Booklet "Evaluation & Management Services Guide" (ICN MLN006764) and AMA CPT © 2025. This tool shows CMS public-domain time thresholds + general MDM framework only; refer to AMA CPT for the licensed code descriptors.

Select a setting on the left

Code	Short Description	Total Time (min)	Work RVU	MDM Level	Allowed (Non-Fac, National)	Reference
Choose a setting from the left rail.

Code	Description	Flags
Enter a search term above.

ICD-10-CM Code Validator

Enter one or more ICD-10-CM codes (comma-separated). The validator checks: (1) is the code present in FY2026? (2) is it billable (a leaf code) or just a header? (3) is it POA-exempt? (4) does it carry Excludes1 / Excludes2 notes?

Code	Status	Description	POA Exempt	Notes
No codes validated yet.

Family Details

Code Family

LCD Reference

LCD ID	Contractor	LCD Description
No LCDs Found

Code	Description
Enter a 7-character code or a description above.

A. Problems Addressed

B. Data Reviewed

C. Risk