NCCI edits for CPT 43200
CMS lists 153 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 220 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.
- 00520 00520 denies
- 00731 00731 denies
- 00732 00732 denies
- 00811 00811 denies
- 00812 00812 denies
- 00813 00813 denies
- 0213T 0213T denies
- 0216T 0216T denies
- 0397T 43200 denies
- 0652T 43200 denies
- 0653T 43200 denies
- 0654T 43200 denies
- 0884T 43200 denies
- 31505 31505 denies
- 31575 31575 denies
- 36591 36591 denies
- 36592 36592 denies
- 43180 43200 denies
- 43191 43200 denies
- 43192 43200 denies
- 43193 43200 denies
- 43194 43200 denies
- 43195 43200 denies
- 43196 43200 denies
- 43197 43197 denies
- 43198 43200 denies
- 43201 43200 denies
- 43202 43200 denies
- 43204 43200 denies
- 43205 43200 denies
- 43206 43200 denies
- 43210 43200 denies
- 43211 43200 denies
- 43212 43200 denies
- 43213 43200 denies
- 43214 43200 denies
- 43215 43200 denies
- 43216 43200 denies
- 43217 43200 denies
- 43220 43200 denies
- 43226 43200 denies
- 43227 43200 denies
- 43229 43200 denies
- 43231 43200 denies
- 43232 43200 denies
- 43233 43200 denies
- 43235 43200 denies
- 43236 43200 denies
- 43237 43200 denies
- 43238 43200 denies
Showing 50 of 153. The plain-text version contains every pair.
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.
- 0596T 0596T denies
- 0597T 0597T denies
- 0632T 0632T denies
- 0647T 43200 denies
- 0708T 0708T denies
- 0709T 0709T denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T 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
- 12045 12045 denies
- 12046 12046 denies
- 12047 12047 denies
- 12051 12051 denies
- 12052 12052 denies
- 12053 12053 denies
- 12054 12054 denies
- 12055 12055 denies
- 12056 12056 denies
- 12057 12057 denies
- 13100 13100 denies
- 13101 13101 denies
- 13102 13102 denies
- 13120 13120 denies
- 13121 13121 denies
- 13122 13122 denies
- 13131 13131 denies
Showing 50 of 220. 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.