NCCI edits for CPT 55865
CMS lists 83 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 184 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.
- 0213T 0213T denies
- 0216T 0216T denies
- 0433U 0433U denies
- 36591 36591 denies
- 36592 36592 denies
- 38562 38562 denies
- 38573 38573 denies
- 38770 38770 denies
- 44005 44005 denies
- 44180 44180 denies
- 44820 44820 denies
- 44850 44850 denies
- 44950 44950 denies
- 44970 44970 denies
- 49000 49000 denies
- 49010 49010 denies
- 49255 49255 denies
- 51701 51701 denies
- 51702 51702 denies
- 62320 62320 denies
- 62321 62321 denies
- 62322 62322 denies
- 62323 62323 denies
- 62324 62324 denies
- 62325 62325 denies
- 62326 62326 denies
- 62327 62327 denies
- 64400 64400 denies
- 64405 64405 denies
- 64408 64408 denies
- 64415 64415 denies
- 64416 64416 denies
- 64417 64417 denies
- 64418 64418 denies
- 64420 64420 denies
- 64421 64421 denies
- 64425 64425 denies
- 64430 64430 denies
- 64435 64435 denies
- 64445 64445 denies
- 64446 64446 denies
- 64447 64447 denies
- 64448 64448 denies
- 64449 64449 denies
- 64450 64450 denies
- 64451 64451 denies
- 64454 64454 denies
- 64461 64461 denies
- 64462 64462 denies
- 64463 64463 denies
Showing 50 of 83. 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.
- 0403U 0403U denies
- 0424U 0424U denies
- 0596T 0596T denies
- 0597T 0597T denies
- 0600T 0600T denies
- 0601T 0601T denies
- 0708T 0708T denies
- 0709T 0709T denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T denies
- 11000 11000 denies
- 11001 11001 denies
- 11004 11004 denies
- 11005 11005 denies
- 11006 11006 denies
- 11042 11042 denies
- 11043 11043 denies
- 11044 11044 denies
- 11045 11045 denies
- 11046 11046 denies
- 11047 11047 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
Showing 50 of 184. 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.