NCCI edits for HCPCS A9536
CMS lists 22 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 1 pair 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.
- 0868T A9536 denies
- 78215 A9536 denies
- 78226 A9536 denies
- 78227 A9536 denies
- 78264 A9536 denies
- 78265 A9536 denies
- 78266 A9536 denies
- 78290 A9536 denies
- 78306 A9536 denies
- 78315 A9536 denies
- 78452 A9536 denies
- 78472 A9536 denies
- 78579 A9536 denies
- 78580 A9536 denies
- 78582 A9536 denies
- 78597 A9536 denies
- 78598 A9536 denies
- 78701 A9536 denies
- 78707 A9536 denies
- 78708 A9536 denies
- 78709 A9536 denies
- A9512 A9512 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.
- 78803 A9536 denies
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.