NCCI edits for CPT 96542
CMS lists 3 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 102 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.
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.
- 0708T 0708T denies
- 0709T 0709T denies
- 11900 11900 denies
- 11901 11901 denies
- 36000 36000 denies
- 36410 36410 denies
- 61070 61070 denies
- 62270 62270 denies
- 62272 62272 denies
- 62328 62328 denies
- 62329 62329 denies
- 64450 64450 denies
- 64454 64454 denies
- 64473 64473 denies
- 64474 64474 denies
- 64486 64486 denies
- 64487 64487 denies
- 64488 64488 denies
- 64489 64489 denies
- 79200 79200 denies
- 96372 96372 denies
- 96377 96377 denies
- 96521 96521 denies
- 96522 96522 denies
- 99202 99202 denies
- 99203 99203 denies
- 99204 99204 denies
- 99205 99205 denies
- 99211 99211 denies
- 99212 99212 denies
- 99213 99213 denies
- 99214 99214 denies
- 99215 99215 denies
- 99221 99221 denies
- 99222 99222 denies
- 99223 99223 denies
- 99231 99231 denies
- 99232 99232 denies
- 99233 99233 denies
- 99234 99234 denies
- 99235 99235 denies
- 99236 99236 denies
- 99238 99238 denies
- 99239 99239 denies
- 99281 99281 denies
- 99282 99282 denies
- 99283 99283 denies
- 99284 99284 denies
- 99285 99285 denies
- 99291 99291 denies
Showing 50 of 102. 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.