NCCI edits for CPT 0403T
CMS lists 4 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 34 pairs with modifier indicator 1, where an NCCI-associated modifier may be allowed when the documentation supports it.
NCCI release: Q4 2026. Source: CMS National Correct Coding Initiative (NCCI) Edits. Complete plain-text list.
Check a paired code Copy link
Medically Unlikely Edit (MUE) Copy link
The published MUE is 1 unit per patient per date of service.
Not separately payable together Copy link
Modifier indicator 0: the edit cannot be bypassed with an NCCI-associated modifier. Each row names the code that denies. CMS writes every edit as an ordered pair: the Column Two code is denied and the Column One code is paid.
Modifier may be allowed Copy link
Modifier indicator 1: an NCCI-associated modifier may be used when the circumstances and documentation support it. Each row names the Column Two code, which is the one denied absent an allowed modifier.
- 0362T 0403T denies
- 0373T 0403T denies
- 0591T 0403T denies
- 0592T 0403T denies
- 96041 96041 denies
- 96156 0403T denies
- 96158 0403T denies
- 96159 0403T denies
- 96164 0403T denies
- 96165 0403T denies
- 96167 0403T denies
- 96168 0403T denies
- 96170 0403T denies
- 96171 0403T denies
- 97152 0403T denies
- 97153 0403T denies
- 97154 0403T denies
- 97155 0403T denies
- 97156 0403T denies
- 97157 0403T denies
- 97158 0403T denies
- 98960 98960 denies
- 98961 98961 denies
- 98962 98962 denies
- 99401 0403T denies
- 99402 0403T denies
- 99403 0403T denies
- 99404 0403T denies
- 99411 0403T denies
- 99412 0403T denies
- G0442 0403T denies
- G0443 0403T denies
- G0444 0403T denies
- G0445 0403T denies
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.