NCCI edits for CPT 95869
CMS lists 682 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 58 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.
- 00104 95869 denies
- 00210 95869 denies
- 00211 95869 denies
- 00212 95869 denies
- 00214 95869 denies
- 00215 95869 denies
- 00216 95869 denies
- 00218 95869 denies
- 00220 95869 denies
- 00222 95869 denies
- 00300 95869 denies
- 00400 95869 denies
- 00600 95869 denies
- 00604 95869 denies
- 00620 95869 denies
- 00625 95869 denies
- 00626 95869 denies
- 00630 95869 denies
- 00632 95869 denies
- 00635 95869 denies
- 00640 95869 denies
- 00670 95869 denies
- 00700 95869 denies
- 00730 95869 denies
- 00800 95869 denies
- 01250 95869 denies
- 01320 95869 denies
- 01470 95869 denies
- 01610 95869 denies
- 01710 95869 denies
- 01810 95869 denies
- 01924 95869 denies
- 01925 95869 denies
- 01926 95869 denies
- 01930 95869 denies
- 01932 95869 denies
- 01933 95869 denies
- 01937 95869 denies
- 01938 95869 denies
- 01939 95869 denies
- 01940 95869 denies
- 01941 95869 denies
- 01942 95869 denies
- 01991 95869 denies
- 01992 95869 denies
- 0200T 95869 denies
- 0201T 95869 denies
- 0202T 95869 denies
- 0213T 95869 denies
- 0214T 95869 denies
Showing 50 of 682. 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.
- 0947T 95869 denies
- 33280 95869 denies
- 33288 95869 denies
- 64400 95869 denies
- 64405 95869 denies
- 64408 95869 denies
- 64415 95869 denies
- 64416 95869 denies
- 64417 95869 denies
- 64418 95869 denies
- 64420 95869 denies
- 64421 95869 denies
- 64425 95869 denies
- 64430 95869 denies
- 64435 95869 denies
- 64445 95869 denies
- 64446 95869 denies
- 64447 95869 denies
- 64448 95869 denies
- 64449 95869 denies
- 64450 95869 denies
- 64451 95869 denies
- 64454 95869 denies
- 64455 95869 denies
- 64473 95869 denies
- 64474 95869 denies
- 64479 95869 denies
- 64480 95869 denies
- 64483 95869 denies
- 64484 95869 denies
- 64490 95869 denies
- 64491 95869 denies
- 64492 95869 denies
- 64493 95869 denies
- 64494 95869 denies
- 64495 95869 denies
- 64505 95869 denies
- 64510 95869 denies
- 64517 95869 denies
- 64520 95869 denies
- 64530 95869 denies
- 64616 95869 denies
- 90901 90901 denies
- 90912 95869 denies
- 90913 95869 denies
- 95860 95869 denies
- 95861 95869 denies
- 95863 95869 denies
- 95864 95869 denies
- 95867 95869 denies
Showing 50 of 58. 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.