NCCI edits for CPT 99255
CMS lists 42 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 5,842 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 0 units 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
- 36591 36591 denies
- 36592 36592 denies
- 80503 99255 denies
- 80504 99255 denies
- 80505 99255 denies
- 80506 99255 denies
- 90791 99255 denies
- 90792 99255 denies
- 90832 99255 denies
- 90834 99255 denies
- 90837 99255 denies
- 90863 90863 denies
- 93793 93793 denies
- 94002 94002 denies
- 94003 94003 denies
- 94004 94004 denies
- 94660 94660 denies
- 96127 96127 denies
- 96523 96523 denies
- 99091 99091 denies
- 99172 99172 denies
- 99242 99242 denies
- 99243 99243 denies
- 99244 99244 denies
- 99245 99245 denies
- 99446 99446 denies
- 99447 99447 denies
- 99448 99448 denies
- 99449 99449 denies
- 99451 99451 denies
- 99452 99452 denies
- 99474 99474 denies
- G0406 G0406 denies
- G0407 G0407 denies
- G0408 G0408 denies
- G0425 G0425 denies
- G0426 G0426 denies
- G0427 G0427 denies
- G0459 G0459 denies
- G0508 G0508 denies
- G0509 G0509 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.
- 0335T 99255 denies
- 0338T 99255 denies
- 0339T 99255 denies
- 0342T 99255 denies
- 0345T 99255 denies
- 0347T 99255 denies
- 0362T 0362T denies
- 0373T 0373T denies
- 0395T 99255 denies
- 0397T 99255 denies
- 0402T 99255 denies
- 0408T 99255 denies
- 0409T 99255 denies
- 0410T 99255 denies
- 0411T 99255 denies
- 0412T 99255 denies
- 0413T 99255 denies
- 0414T 99255 denies
- 0415T 99255 denies
- 0416T 99255 denies
- 0419T 99255 denies
- 0420T 99255 denies
- 0437T 99255 denies
- 0440T 99255 denies
- 0441T 99255 denies
- 0442T 99255 denies
- 0444T 99255 denies
- 0445T 99255 denies
- 0446T 99255 denies
- 0447T 99255 denies
- 0448T 99255 denies
- 0449T 99255 denies
- 0450T 99255 denies
- 0474T 99255 denies
- 0479T 99255 denies
- 0480T 99255 denies
- 0481T 99255 denies
- 0483T 99255 denies
- 0484T 99255 denies
- 0489T 99255 denies
- 0490T 99255 denies
- 0505T 99255 denies
- 0510T 99255 denies
- 0511T 99255 denies
- 0512T 99255 denies
- 0513T 99255 denies
- 0515T 99255 denies
- 0516T 99255 denies
- 0517T 99255 denies
- 0518T 99255 denies
Showing 50 of 5,842. 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.