NCCI edits for CPT 94004
CMS lists 190 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 280 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.
- 0591T 94004 denies
- 0592T 94004 denies
- 0593T 94004 denies
- 0734T 94004 denies
- 36591 36591 denies
- 36592 36592 denies
- 94003 94004 denies
- 94375 94375 denies
- 94450 94450 denies
- 94660 94660 denies
- 96160 94004 denies
- 96161 94004 denies
- 96523 96523 denies
- 98000 94004 denies
- 98001 94004 denies
- 98002 94004 denies
- 98003 94004 denies
- 98004 94004 denies
- 98005 94004 denies
- 98006 94004 denies
- 98007 94004 denies
- 98008 94004 denies
- 98009 94004 denies
- 98010 94004 denies
- 98011 94004 denies
- 98012 94004 denies
- 98013 94004 denies
- 98014 94004 denies
- 98015 94004 denies
- 98016 94004 denies
- 99202 94004 denies
- 99203 94004 denies
- 99204 94004 denies
- 99205 94004 denies
- 99211 94004 denies
- 99212 94004 denies
- 99213 94004 denies
- 99214 94004 denies
- 99215 94004 denies
- 99221 94004 denies
- 99222 94004 denies
- 99223 94004 denies
- 99231 94004 denies
- 99232 94004 denies
- 99233 94004 denies
- 99234 94004 denies
- 99235 94004 denies
- 99236 94004 denies
- 99238 94004 denies
- 99239 94004 denies
Showing 50 of 190. 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 94004 denies
- 00102 94004 denies
- 00103 94004 denies
- 00104 94004 denies
- 00120 94004 denies
- 00124 94004 denies
- 00126 94004 denies
- 00140 94004 denies
- 00142 94004 denies
- 00144 94004 denies
- 00145 94004 denies
- 00147 94004 denies
- 00148 94004 denies
- 00160 94004 denies
- 00162 94004 denies
- 00164 94004 denies
- 00170 94004 denies
- 00172 94004 denies
- 00174 94004 denies
- 00176 94004 denies
- 00190 94004 denies
- 00192 94004 denies
- 00210 94004 denies
- 00211 94004 denies
- 00212 94004 denies
- 00214 94004 denies
- 00215 94004 denies
- 00216 94004 denies
- 00218 94004 denies
- 00220 94004 denies
- 00222 94004 denies
- 00300 94004 denies
- 00320 94004 denies
- 00322 94004 denies
- 00326 94004 denies
- 00350 94004 denies
- 00352 94004 denies
- 00400 94004 denies
- 00402 94004 denies
- 00404 94004 denies
- 00406 94004 denies
- 00410 94004 denies
- 00450 94004 denies
- 00454 94004 denies
- 00470 94004 denies
- 00472 94004 denies
- 00474 94004 denies
- 00500 94004 denies
- 00520 94004 denies
- 00522 94004 denies
Showing 50 of 280. 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.