NCCI edits for CPT 92604
CMS lists 33 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 20 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.
- 0208T 0208T denies
- 0209T 0209T denies
- 0210T 0210T denies
- 0211T 0211T denies
- 0212T 0212T denies
- 36591 36591 denies
- 36592 36592 denies
- 92552 92552 denies
- 92553 92553 denies
- 92555 92555 denies
- 92556 92556 denies
- 92557 92557 denies
- 92558 92558 denies
- 92562 92562 denies
- 92563 92563 denies
- 92565 92565 denies
- 92571 92571 denies
- 92572 92572 denies
- 92575 92575 denies
- 92576 92576 denies
- 92577 92577 denies
- 92579 92579 denies
- 92582 92582 denies
- 92583 92583 denies
- 92584 92584 denies
- 92587 92587 denies
- 92588 92588 denies
- 92596 92596 denies
- 92597 92597 denies
- 92601 92604 denies
- 92602 92604 denies
- 96523 96523 denies
- 97755 97755 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.
- 0485T 0485T denies
- 0486T 0486T denies
- 0728T 92604 denies
- 0729T 0729T denies
- 92507 92507 denies
- 92508 92508 denies
- 92521 92521 denies
- 92522 92522 denies
- 92523 92523 denies
- 92524 92524 denies
- 92550 92550 denies
- 92567 92567 denies
- 92568 92568 denies
- 92570 92570 denies
- 92603 92604 denies
- 92626 92626 denies
- 92650 92650 denies
- 92651 92651 denies
- 92652 92652 denies
- 92653 92653 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.