NCCI edits for CPT 20604
CMS lists 24 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 683 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 4 units 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.
- 00400 00400 denies
- 01380 01380 denies
- 36591 36591 denies
- 36592 36592 denies
- 64461 64461 denies
- 64462 64462 denies
- 64463 64463 denies
- 64480 64480 denies
- 64484 64484 denies
- 64491 64491 denies
- 64492 64492 denies
- 64494 64494 denies
- 64495 64495 denies
- 69990 69990 denies
- 96523 96523 denies
- 99155 99155 denies
- 99156 99156 denies
- 99157 99157 denies
- 99446 99446 denies
- 99447 99447 denies
- 99448 99448 denies
- 99449 99449 denies
- 99451 99451 denies
- 99452 99452 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.
- 0213T 0213T denies
- 0216T 0216T denies
- 0232T 0232T denies
- 0335T 20604 denies
- 0481T 0481T denies
- 0489T 20604 denies
- 0490T 20604 denies
- 0510T 20604 denies
- 0511T 20604 denies
- 0596T 0596T denies
- 0597T 0597T denies
- 0656T 20604 denies
- 0657T 20604 denies
- 0717T 20604 denies
- 0718T 20604 denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T denies
- 10030 10030 denies
- 10060 10060 denies
- 10061 10061 denies
- 10140 10140 denies
- 10160 10160 denies
- 11000 20604 denies
- 11010 20604 denies
- 11719 11719 denies
- 12001 12001 denies
- 12002 12002 denies
- 12004 12004 denies
- 12005 12005 denies
- 12006 12006 denies
- 12007 12007 denies
- 12011 12011 denies
- 12013 12013 denies
- 12014 12014 denies
- 12015 12015 denies
- 12016 12016 denies
- 12017 12017 denies
- 12018 12018 denies
- 12020 12020 denies
- 12021 12021 denies
- 12031 12031 denies
- 12032 12032 denies
- 12034 12034 denies
- 12035 12035 denies
- 12036 12036 denies
- 12037 12037 denies
- 12041 12041 denies
- 12042 12042 denies
- 12044 12044 denies
Showing 50 of 683. The plain-text version contains every pair.
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.