NCCI edits for HCPCS A9538
CMS lists 25 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 0 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.
- 0868T A9538 denies
- 78070 A9538 denies
- 78202 A9538 denies
- 78215 A9538 denies
- 78226 A9538 denies
- 78227 A9538 denies
- 78264 A9538 denies
- 78265 A9538 denies
- 78266 A9538 denies
- 78278 A9538 denies
- 78290 A9538 denies
- 78305 A9538 denies
- 78451 A9538 denies
- 78452 A9538 denies
- 78472 A9538 denies
- 78473 A9538 denies
- 78481 A9538 denies
- 78483 A9538 denies
- 78494 A9538 denies
- 78580 A9538 denies
- 78597 A9538 denies
- 78709 A9538 denies
- 78808 A9538 denies
- 78815 A9538 denies
- A9512 A9512 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.