NCCI edits for CPT 0863T
CMS lists 43 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 23 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.
- 0515T 0863T denies
- 0517T 0863T denies
- 0518T 0863T denies
- 0519T 0863T denies
- 0520T 0863T denies
- 0521T 0863T denies
- 0522T 0522T denies
- 0861T 0861T denies
- 36591 36591 denies
- 36592 36592 denies
- 76998 76998 denies
- 93303 93303 denies
- 93304 93304 denies
- 93306 93306 denies
- 93307 93307 denies
- 93308 93308 denies
- 93312 93312 denies
- 93313 93313 denies
- 93314 93314 denies
- 93315 93315 denies
- 93316 93316 denies
- 93317 93317 denies
- 93318 93318 denies
- 93319 93319 denies
- 93320 93320 denies
- 93321 93321 denies
- 93325 93325 denies
- 93350 93350 denies
- 93351 93351 denies
- 93352 93352 denies
- 93355 93355 denies
- 93452 93452 denies
- 93453 93453 denies
- 93458 93458 denies
- 93459 93459 denies
- 93460 93460 denies
- 93461 93461 denies
- 93565 93565 denies
- 93586 93586 denies
- 93595 93595 denies
- 93596 93596 denies
- 93597 93597 denies
- 96523 96523 denies
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.
- 0932T 0932T denies
- 11000 11000 denies
- 11004 11004 denies
- 11005 11005 denies
- 11006 11006 denies
- 11042 11042 denies
- 11043 11043 denies
- 11044 11044 denies
- 35231 35231 denies
- 35236 35236 denies
- 35241 35241 denies
- 35246 35246 denies
- 35251 35251 denies
- 35256 35256 denies
- 35261 35261 denies
- 35266 35266 denies
- 35271 35271 denies
- 35276 35276 denies
- 35281 35281 denies
- 35286 35286 denies
- 76000 76000 denies
- 97597 97597 denies
- 97602 97602 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.