NCCI edits for CPT 99454
CMS lists 95 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 11 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.
- 0378T 99454 denies
- 0379T 99454 denies
- 0578T 99454 denies
- 0579T 99454 denies
- 0734T 99454 denies
- 0741T 99454 denies
- 0811T 0811T denies
- 0812T 0812T denies
- 0937T 0937T denies
- 0938T 0938T denies
- 0939T 0939T denies
- 0940T 0940T denies
- 36591 36591 denies
- 36592 36592 denies
- 80503 99454 denies
- 80504 99454 denies
- 80505 99454 denies
- 80506 99454 denies
- 93224 99454 denies
- 93225 99454 denies
- 93226 99454 denies
- 93227 99454 denies
- 93228 99454 denies
- 93229 99454 denies
- 93241 93241 denies
- 93242 93242 denies
- 93243 93243 denies
- 93244 93244 denies
- 93245 93245 denies
- 93246 93246 denies
- 93247 93247 denies
- 93248 93248 denies
- 93264 99454 denies
- 93268 99454 denies
- 93270 99454 denies
- 93271 99454 denies
- 93272 99454 denies
- 93293 99454 denies
- 93294 99454 denies
- 93295 99454 denies
- 93296 99454 denies
- 93297 99454 denies
- 93298 99454 denies
- 93745 99454 denies
- 93784 99454 denies
- 93786 99454 denies
- 93788 99454 denies
- 93790 99454 denies
- 94014 99454 denies
- 94015 99454 denies
Showing 50 of 95. 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.
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.