NCCI edits for CPT 93243
CMS lists 30 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 81 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.
- 0733T 93243 denies
- 36591 36591 denies
- 36592 36592 denies
- 93224 93243 denies
- 93225 93243 denies
- 93226 93243 denies
- 93227 93243 denies
- 93228 93243 denies
- 93229 93243 denies
- 93241 93243 denies
- 93245 93243 denies
- 93246 93243 denies
- 93247 93243 denies
- 93248 93243 denies
- 93268 93243 denies
- 93270 93243 denies
- 93271 93243 denies
- 93272 93243 denies
- 96523 96523 denies
- 98975 93243 denies
- 98976 93243 denies
- 98977 93243 denies
- 99091 93243 denies
- 99453 93243 denies
- 99454 93243 denies
- 99473 99473 denies
- G0248 93243 denies
- G0398 93243 denies
- G0399 93243 denies
- G0400 93243 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.
- 0417T 93243 denies
- 0418T 93243 denies
- 0521T 93243 denies
- 0522T 93243 denies
- 0525T 93243 denies
- 0526T 93243 denies
- 0527T 93243 denies
- 0528T 93243 denies
- 0575T 93243 denies
- 0576T 93243 denies
- 0578T 93243 denies
- 0579T 93243 denies
- 0650T 93243 denies
- 0659T 93243 denies
- 0696T 93243 denies
- 0897T 0897T denies
- 0902T 93243 denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T denies
- 0913T 93243 denies
- 0928T 93243 denies
- 0929T 0929T denies
- 0934T 93243 denies
- 92920 93243 denies
- 92924 93243 denies
- 92928 93243 denies
- 92933 93243 denies
- 92937 93243 denies
- 92941 93243 denies
- 92943 93243 denies
- 92972 93243 denies
- 93000 93000 denies
- 93005 93005 denies
- 93010 93010 denies
- 93040 93040 denies
- 93041 93041 denies
- 93042 93042 denies
- 93260 93243 denies
- 93261 93243 denies
- 93264 93243 denies
- 93279 93243 denies
- 93280 93243 denies
- 93281 93243 denies
- 93282 93243 denies
- 93283 93243 denies
- 93284 93243 denies
- 93285 93243 denies
- 93286 93243 denies
- 93287 93243 denies
Showing 50 of 81. 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.