NCCI edits for CPT 98004
CMS lists 69 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 137 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.
- 0469T 0469T denies
- 0734T 98004 denies
- 36591 36591 denies
- 36592 36592 denies
- 90791 98004 denies
- 90792 98004 denies
- 90832 98004 denies
- 90834 98004 denies
- 90837 98004 denies
- 93792 93792 denies
- 93793 93793 denies
- 94002 94002 denies
- 94003 94003 denies
- 94004 94004 denies
- 94660 94660 denies
- 96127 96127 denies
- 96523 96523 denies
- 98966 98966 denies
- 98967 98967 denies
- 98968 98004 denies
- 99172 99172 denies
- 99202 98004 denies
- 99203 98004 denies
- 99204 98004 denies
- 99205 98004 denies
- 99211 99211 denies
- 99212 99212 denies
- 99213 98004 denies
- 99214 98004 denies
- 99215 98004 denies
- 99242 98004 denies
- 99243 98004 denies
- 99244 98004 denies
- 99245 98004 denies
- 99374 98004 denies
- 99375 98004 denies
- 99377 98004 denies
- 99378 98004 denies
- 99379 98004 denies
- 99380 98004 denies
- 99421 99421 denies
- 99423 98004 denies
- 99446 99446 denies
- 99447 98004 denies
- 99448 98004 denies
- 99449 98004 denies
- 99451 98004 denies
- 99452 98004 denies
- 99474 99474 denies
- 99484 98004 denies
Showing 50 of 69. 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.
- 0362T 0362T denies
- 0373T 0373T denies
- 0395T 98004 denies
- 77261 98004 denies
- 77262 98004 denies
- 77263 98004 denies
- 77280 98004 denies
- 77285 98004 denies
- 77290 98004 denies
- 77295 98004 denies
- 77300 98004 denies
- 77301 98004 denies
- 77306 98004 denies
- 77307 98004 denies
- 77316 98004 denies
- 77317 98004 denies
- 77318 98004 denies
- 77321 98004 denies
- 77331 98004 denies
- 77332 98004 denies
- 77333 98004 denies
- 77334 98004 denies
- 77336 98004 denies
- 77338 98004 denies
- 77370 98004 denies
- 77371 98004 denies
- 77372 98004 denies
- 77373 98004 denies
- 77417 98004 denies
- 77423 98004 denies
- 77424 98004 denies
- 77425 98004 denies
- 77427 98004 denies
- 77431 98004 denies
- 77432 98004 denies
- 77435 98004 denies
- 77469 98004 denies
- 77470 98004 denies
- 77520 98004 denies
- 77522 98004 denies
- 77523 98004 denies
- 77525 98004 denies
- 77600 98004 denies
- 77605 98004 denies
- 77610 98004 denies
- 77615 98004 denies
- 77620 98004 denies
- 77750 98004 denies
- 77761 98004 denies
- 77762 98004 denies
Showing 50 of 137. 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.