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NCCI edits for CPT 95004

CMS lists 3 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 192 pairs with modifier indicator 1, where an NCCI-associated modifier may be allowed when the documentation supports it.

NCCI release: Q3 2026. Source: CMS National Correct Coding Initiative (NCCI) Edits. Complete plain-text list.

Check a paired code Copy link

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, and it is the Column Two code that is denied while Column One 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.

Showing 50 of 192. 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.