NCCI edits for CPT 99245
CMS lists 53 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 5,843 pairs with modifier indicator 1, where an NCCI-associated modifier may be allowed when the documentation supports it.
NCCI release: Q3 2026. Source: CMS National Correct Coding Initiative (NCCI) Edits. Complete plain-text list.
Check a paired code Copy link
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.
- 0469T 0469T denies
- 36591 36591 denies
- 36592 36592 denies
- 80503 99245 denies
- 80504 99245 denies
- 80505 99245 denies
- 80506 99245 denies
- 90791 99245 denies
- 90792 99245 denies
- 90832 99245 denies
- 90834 99245 denies
- 90837 99245 denies
- 90863 90863 denies
- 93793 93793 denies
- 94002 94002 denies
- 94003 94003 denies
- 94004 94004 denies
- 94660 94660 denies
- 96523 96523 denies
- 98000 98000 denies
- 98001 98001 denies
- 98002 98002 denies
- 98003 98003 denies
- 98004 98004 denies
- 98005 98005 denies
- 98006 98006 denies
- 98007 98007 denies
- 99091 99091 denies
- 99172 99172 denies
- 99252 99245 denies
- 99253 99245 denies
- 99254 99245 denies
- 99255 99245 denies
- 99421 99421 denies
- 99422 99422 denies
- 99423 99423 denies
- 99446 99446 denies
- 99447 99447 denies
- 99448 99448 denies
- 99449 99449 denies
- 99451 99451 denies
- 99452 99452 denies
- 99474 99474 denies
- 99483 99245 denies
- G0406 G0406 denies
- G0407 G0407 denies
- G0408 G0408 denies
- G0425 G0425 denies
- G0426 G0426 denies
- G0427 G0427 denies
Showing 50 of 53. 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.
- 0335T 99245 denies
- 0338T 99245 denies
- 0339T 99245 denies
- 0342T 99245 denies
- 0345T 99245 denies
- 0347T 99245 denies
- 0362T 0362T denies
- 0373T 0373T denies
- 0395T 99245 denies
- 0397T 99245 denies
- 0402T 99245 denies
- 0408T 99245 denies
- 0409T 99245 denies
- 0410T 99245 denies
- 0411T 99245 denies
- 0412T 99245 denies
- 0413T 99245 denies
- 0414T 99245 denies
- 0415T 99245 denies
- 0416T 99245 denies
- 0419T 99245 denies
- 0420T 99245 denies
- 0437T 99245 denies
- 0440T 99245 denies
- 0441T 99245 denies
- 0442T 99245 denies
- 0444T 99245 denies
- 0445T 99245 denies
- 0446T 99245 denies
- 0447T 99245 denies
- 0448T 99245 denies
- 0449T 99245 denies
- 0450T 99245 denies
- 0474T 99245 denies
- 0479T 99245 denies
- 0480T 99245 denies
- 0481T 99245 denies
- 0483T 99245 denies
- 0484T 99245 denies
- 0489T 99245 denies
- 0490T 99245 denies
- 0505T 99245 denies
- 0510T 99245 denies
- 0511T 99245 denies
- 0512T 99245 denies
- 0513T 99245 denies
- 0515T 99245 denies
- 0516T 99245 denies
- 0517T 99245 denies
- 0518T 99245 denies
Showing 50 of 5,843. 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.