NCCI edits for CPT 53865
CMS lists 148 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 137 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.
- 00910 00910 denies
- 00916 00916 denies
- 00918 00918 denies
- 0213T 0213T denies
- 0216T 0216T denies
- 0596T 0596T denies
- 0597T 0597T denies
- 36591 36591 denies
- 36592 36592 denies
- 36593 36593 denies
- 51701 51701 denies
- 51702 51702 denies
- 51703 51703 denies
- 52000 52000 denies
- 52005 53865 denies
- 52007 53865 denies
- 52010 53865 denies
- 52204 53865 denies
- 52214 53865 denies
- 52224 53865 denies
- 52234 53865 denies
- 52235 53865 denies
- 52240 53865 denies
- 52250 53865 denies
- 52260 53865 denies
- 52265 53865 denies
- 52275 53865 denies
- 52276 53865 denies
- 52277 53865 denies
- 52281 52281 denies
- 52282 53865 denies
- 52283 53865 denies
- 52284 53865 denies
- 52287 53865 denies
- 52290 53865 denies
- 52300 53865 denies
- 52301 53865 denies
- 52305 53865 denies
- 52310 52310 denies
- 52315 52315 denies
- 52320 53865 denies
- 52325 53865 denies
- 52327 53865 denies
- 52330 53865 denies
- 52332 53865 denies
- 52334 53865 denies
- 52341 53865 denies
- 52342 53865 denies
- 52343 53865 denies
- 52344 53865 denies
Showing 50 of 148. 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.
- 0582T 53865 denies
- 0655T 53865 denies
- 0708T 0708T denies
- 0714T 53865 denies
- 11000 11000 denies
- 11004 11004 denies
- 11005 11005 denies
- 11006 11006 denies
- 11042 11042 denies
- 11043 11043 denies
- 11044 11044 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
- 13120 13120 denies
- 13121 13121 denies
- 13131 13131 denies
Showing 50 of 137. 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.