NCCI edits for CPT 90474
CMS lists 3 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 54 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.
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.
- 0591T 0591T denies
- 0592T 0592T denies
- 0593T 0593T denies
- 96160 96160 denies
- 96161 96161 denies
- 99202 99202 denies
- 99203 99203 denies
- 99204 99204 denies
- 99205 99205 denies
- 99211 99211 denies
- 99212 99212 denies
- 99213 99213 denies
- 99214 99214 denies
- 99215 99215 denies
- 99242 99242 denies
- 99243 99243 denies
- 99244 99244 denies
- 99245 99245 denies
- 99281 99281 denies
- 99282 99282 denies
- 99283 99283 denies
- 99284 99284 denies
- 99285 99285 denies
- 99381 99381 denies
- 99382 99382 denies
- 99383 99383 denies
- 99384 99384 denies
- 99385 99385 denies
- 99386 99386 denies
- 99387 99387 denies
- 99391 99391 denies
- 99392 99392 denies
- 99393 99393 denies
- 99394 99394 denies
- 99395 99395 denies
- 99396 99396 denies
- 99397 99397 denies
- 99401 99401 denies
- 99402 99402 denies
- 99403 99403 denies
- 99404 99404 denies
- 99406 99406 denies
- 99407 99407 denies
- 99408 99408 denies
- 99409 99409 denies
- 99411 99411 denies
- 99412 99412 denies
- 99483 99483 denies
- 99497 99497 denies
- G0442 G0442 denies
Showing 50 of 54. 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.