NCCI edits for CPT 96380
CMS lists 5 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 55 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, 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.
- 99202 99202 denies
- 99203 99203 denies
- 99204 99204 denies
- 99205 99205 denies
- 99212 99212 denies
- 99213 99213 denies
- 99214 99214 denies
- 99215 99215 denies
- 99221 96380 denies
- 99222 96380 denies
- 99223 96380 denies
- 99231 96380 denies
- 99232 96380 denies
- 99233 96380 denies
- 99234 96380 denies
- 99235 96380 denies
- 99236 96380 denies
- 99238 96380 denies
- 99239 96380 denies
- 99281 96380 denies
- 99282 96380 denies
- 99283 96380 denies
- 99284 96380 denies
- 99285 96380 denies
- 99288 96380 denies
- 99291 96380 denies
- 99304 96380 denies
- 99305 96380 denies
- 99306 96380 denies
- 99307 96380 denies
- 99308 96380 denies
- 99309 96380 denies
- 99310 96380 denies
- 99315 96380 denies
- 99316 96380 denies
- 99341 96380 denies
- 99342 96380 denies
- 99344 96380 denies
- 99345 96380 denies
- 99347 96380 denies
- 99348 96380 denies
- 99349 96380 denies
- 99350 96380 denies
- 99358 96380 denies
- 99456 99456 denies
- 99460 96380 denies
- 99461 96380 denies
- 99462 96380 denies
- 99463 96380 denies
- 99465 96380 denies
Showing 50 of 55. 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.