NCCI edits for HCPCS G0397
CMS lists 18 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 97 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.
- 36591 36591 denies
- 36592 36592 denies
- 96156 G0397 denies
- 96158 G0397 denies
- 96159 96159 denies
- 96164 96164 denies
- 96165 96165 denies
- 96167 G0397 denies
- 96168 96168 denies
- 96202 G0397 denies
- 96203 G0397 denies
- 96523 96523 denies
- 99408 99408 denies
- 99409 99409 denies
- G0396 G0396 denies
- G0442 G0442 denies
- G0443 G0397 denies
- G2011 G2011 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.
- 90791 G0397 denies
- 90792 G0397 denies
- 90832 G0397 denies
- 90833 G0397 denies
- 90834 G0397 denies
- 90836 G0397 denies
- 90837 G0397 denies
- 90838 G0397 denies
- 90839 G0397 denies
- 90840 G0397 denies
- 90845 G0397 denies
- 90846 G0397 denies
- 90847 G0397 denies
- 90849 G0397 denies
- 90853 G0397 denies
- 90880 G0397 denies
- 96160 96160 denies
- 96161 96161 denies
- 96170 G0397 denies
- 96171 G0397 denies
- 99202 G0397 denies
- 99203 G0397 denies
- 99204 G0397 denies
- 99205 G0397 denies
- 99211 G0397 denies
- 99212 G0397 denies
- 99213 G0397 denies
- 99214 G0397 denies
- 99215 G0397 denies
- 99221 G0397 denies
- 99222 G0397 denies
- 99223 G0397 denies
- 99231 G0397 denies
- 99232 G0397 denies
- 99233 G0397 denies
- 99234 G0397 denies
- 99235 G0397 denies
- 99236 G0397 denies
- 99238 G0397 denies
- 99239 G0397 denies
- 99281 G0397 denies
- 99282 G0397 denies
- 99283 G0397 denies
- 99284 G0397 denies
- 99285 G0397 denies
- 99291 G0397 denies
- 99292 G0397 denies
- 99304 G0397 denies
- 99305 G0397 denies
- 99306 G0397 denies
Showing 50 of 97. 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.