NCCI edits for CPT 96138
CMS lists 18 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 97 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.
- 0362T 0362T denies
- 0373T 0373T denies
- 36591 36591 denies
- 36592 36592 denies
- 90785 90785 denies
- 96112 96138 denies
- 96127 96127 denies
- 96146 96146 denies
- 96523 96523 denies
- 97151 97151 denies
- 97152 97152 denies
- 97153 97153 denies
- 97154 97154 denies
- 97155 97155 denies
- 97156 97156 denies
- 97157 97157 denies
- 97158 97158 denies
- 99483 96138 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.
- 92521 96138 denies
- 92522 96138 denies
- 92523 96138 denies
- 92524 96138 denies
- 96020 96138 denies
- 96110 96110 denies
- 96113 96113 denies
- 96125 96125 denies
- 96136 96138 denies
- 96137 96138 denies
- 96156 96138 denies
- 96158 96138 denies
- 96159 96138 denies
- 96160 96160 denies
- 96161 96161 denies
- 97161 96138 denies
- 97162 96138 denies
- 97163 96138 denies
- 97164 96138 denies
- 97165 96138 denies
- 97166 96138 denies
- 97167 96138 denies
- 97168 96138 denies
- 99202 96138 denies
- 99203 96138 denies
- 99204 96138 denies
- 99205 96138 denies
- 99211 96138 denies
- 99212 96138 denies
- 99213 96138 denies
- 99214 96138 denies
- 99215 96138 denies
- 99221 96138 denies
- 99222 96138 denies
- 99223 96138 denies
- 99231 96138 denies
- 99232 96138 denies
- 99233 96138 denies
- 99234 96138 denies
- 99235 96138 denies
- 99236 96138 denies
- 99238 96138 denies
- 99239 96138 denies
- 99281 96138 denies
- 99282 96138 denies
- 99283 96138 denies
- 99284 96138 denies
- 99285 96138 denies
- 99291 96138 denies
- 99304 96138 denies
Showing 50 of 97. 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.