NCCI edits for CPT 38221
CMS lists 8 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 109 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.
- 0213T 0213T denies
- 0216T 0216T denies
- 0232T 0232T denies
- 0481T 0481T denies
- 0708T 0708T denies
- 0709T 0709T denies
- 10005 10005 denies
- 10007 10007 denies
- 10009 10009 denies
- 10011 10011 denies
- 10021 10021 denies
- 20220 20220 denies
- 20225 38221 denies
- 20240 38221 denies
- 20245 38221 denies
- 20250 38221 denies
- 20251 38221 denies
- 20900 38221 denies
- 20902 38221 denies
- 20937 38221 denies
- 20938 38221 denies
- 22100 38221 denies
- 22101 38221 denies
- 22102 38221 denies
- 22103 38221 denies
- 22110 38221 denies
- 22112 38221 denies
- 22114 38221 denies
- 22116 38221 denies
- 22510 38221 denies
- 22511 38221 denies
- 22512 38221 denies
- 22513 38221 denies
- 22514 38221 denies
- 22515 38221 denies
- 36000 36000 denies
- 36410 36410 denies
- 38220 38220 denies
- 38222 38221 denies
- 61650 61650 denies
- 62324 62324 denies
- 62325 62325 denies
- 62326 62326 denies
- 62327 62327 denies
- 63081 38221 denies
- 63082 38221 denies
- 63085 38221 denies
- 63086 38221 denies
- 63087 38221 denies
- 63088 38221 denies
Showing 50 of 109. 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.