NCCI edits for CPT 90865
CMS lists 100 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 307 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.
- 0362T 0362T denies
- 0373T 0373T denies
- 36591 36591 denies
- 36592 36592 denies
- 90791 90865 denies
- 90792 90865 denies
- 90832 90832 denies
- 90833 90833 denies
- 90834 90834 denies
- 90836 90836 denies
- 90837 90837 denies
- 90838 90838 denies
- 90839 90865 denies
- 90840 90865 denies
- 90845 90865 denies
- 96127 96127 denies
- 96156 96156 denies
- 96158 96158 denies
- 96159 96159 denies
- 96164 96164 denies
- 96165 96165 denies
- 96167 96167 denies
- 96168 96168 denies
- 96170 96170 denies
- 96171 96171 denies
- 96523 96523 denies
- 97151 97151 denies
- 97152 97152 denies
- 97153 97153 denies
- 97154 97154 denies
- 97155 97155 denies
- 97156 97156 denies
- 97157 97157 denies
- 97158 90865 denies
- 97802 97802 denies
- 97803 97803 denies
- 97804 97804 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
- 99221 99221 denies
- 99222 99222 denies
- 99223 99223 denies
- 99231 99231 denies
Showing 50 of 100. 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.
- 00100 90865 denies
- 00102 90865 denies
- 00103 90865 denies
- 00104 90865 denies
- 00120 90865 denies
- 00124 90865 denies
- 00126 90865 denies
- 00140 90865 denies
- 00142 90865 denies
- 00144 90865 denies
- 00145 90865 denies
- 00147 90865 denies
- 00148 90865 denies
- 00160 90865 denies
- 00162 90865 denies
- 00164 90865 denies
- 00170 90865 denies
- 00172 90865 denies
- 00174 90865 denies
- 00176 90865 denies
- 00190 90865 denies
- 00192 90865 denies
- 00210 90865 denies
- 00211 90865 denies
- 00212 90865 denies
- 00214 90865 denies
- 00215 90865 denies
- 00216 90865 denies
- 00218 90865 denies
- 00220 90865 denies
- 00222 90865 denies
- 00300 90865 denies
- 00320 90865 denies
- 00322 90865 denies
- 00326 90865 denies
- 00350 90865 denies
- 00352 90865 denies
- 00400 90865 denies
- 00402 90865 denies
- 00404 90865 denies
- 00406 90865 denies
- 00410 90865 denies
- 00450 90865 denies
- 00454 90865 denies
- 00470 90865 denies
- 00472 90865 denies
- 00474 90865 denies
- 00500 90865 denies
- 00520 90865 denies
- 00522 90865 denies
Showing 50 of 307. 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.