NCCI edits for CPT 78226
CMS lists 36 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 35 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, and it is the Column Two code that is denied while Column One is paid.
- 36591 36591 denies
- 36592 36592 denies
- 77790 77790 denies
- 78227 78226 denies
- 78445 78445 denies
- 96523 96523 denies
- A4642 A4642 denies
- A9500 A9500 denies
- A9501 A9501 denies
- A9502 A9502 denies
- A9503 A9503 denies
- A9504 A9504 denies
- A9505 A9505 denies
- A9507 A9507 denies
- A9512 A9512 denies
- A9516 A9516 denies
- A9517 A9517 denies
- A9521 A9521 denies
- A9536 A9536 denies
- A9538 A9538 denies
- A9539 A9539 denies
- A9540 A9540 denies
- A9541 A9541 denies
- A9547 A9547 denies
- A9548 A9548 denies
- A9552 A9552 denies
- A9555 A9555 denies
- A9557 A9557 denies
- A9558 A9558 denies
- A9560 A9560 denies
- A9561 A9561 denies
- A9562 A9562 denies
- A9567 A9567 denies
- A9570 A9570 denies
- A9572 A9572 denies
- A9584 A9584 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.
- 0395T 78226 denies
- 0694T 0694T denies
- 0708T 0708T denies
- 0709T 0709T denies
- 36000 36000 denies
- 36005 36005 denies
- 36410 36410 denies
- 76000 76000 denies
- 76376 76376 denies
- 76377 76377 denies
- 76942 76942 denies
- 76998 76998 denies
- 77001 77001 denies
- 77002 77002 denies
- 77750 78226 denies
- 77761 78226 denies
- 77762 78226 denies
- 77763 78226 denies
- 77767 78226 denies
- 77768 78226 denies
- 77770 78226 denies
- 77771 78226 denies
- 77772 78226 denies
- 77778 78226 denies
- 77789 78226 denies
- 79101 78226 denies
- 96360 96360 denies
- 96365 96365 denies
- 96372 96372 denies
- 96374 96374 denies
- 96375 96375 denies
- 96376 96376 denies
- 96377 96377 denies
- G0458 78226 denies
- J1642 J1642 denies
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.