NCCI edits for CPT 78264
CMS lists 31 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 34 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.
- 36591 36591 denies
- 36592 36592 denies
- 77790 77790 denies
- 78265 78264 denies
- 78266 78264 denies
- 78445 78445 denies
- 79005 78264 denies
- 96523 96523 denies
- A9500 A9500 denies
- A9502 A9502 denies
- A9503 A9503 denies
- A9505 A9505 denies
- A9510 A9510 denies
- A9516 A9516 denies
- A9536 A9536 denies
- A9537 A9537 denies
- A9538 A9538 denies
- A9547 A9547 denies
- A9551 A9551 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
- A9571 A9571 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 0395T denies
- 0694T 0694T denies
- 0708T 0708T denies
- 0709T 0709T denies
- 0868T 0868T 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 77750 denies
- 77761 77761 denies
- 77762 77762 denies
- 77763 77763 denies
- 77767 78264 denies
- 77768 78264 denies
- 77770 78264 denies
- 77771 78264 denies
- 77772 78264 denies
- 77778 77778 denies
- 77789 77789 denies
- 96360 96360 denies
- 96365 96365 denies
- 96372 96372 denies
- 96374 96374 denies
- 96375 96375 denies
- 96376 96376 denies
- 96377 96377 denies
- A9556 A9556 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.