NCCI edits for HCPCS G0423
CMS lists 11 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 44 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 6 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.
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.
- 0596T 0596T denies
- 0597T 0597T denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T denies
- 36000 36000 denies
- 36410 36410 denies
- 51701 51701 denies
- 51702 51702 denies
- 51703 51703 denies
- 93000 93000 denies
- 93005 93005 denies
- 93010 93010 denies
- 93015 93015 denies
- 93017 93017 denies
- 93018 93018 denies
- 93025 93025 denies
- 93040 93040 denies
- 93041 93041 denies
- 93042 93042 denies
- 93268 93268 denies
- 93351 G0423 denies
- 94625 94625 denies
- 94626 94626 denies
- 97110 97110 denies
- 97112 97112 denies
- 97116 97116 denies
- 97140 97140 denies
- 97150 97150 denies
- 97161 97161 denies
- 97162 97162 denies
- 97163 97163 denies
- 97164 97164 denies
- 97165 97165 denies
- 97166 97166 denies
- 97167 97167 denies
- 97168 97168 denies
- 97530 97530 denies
- 97750 97750 denies
- 97802 97802 denies
- 97803 97803 denies
- 97804 97804 denies
- G0422 G0423 denies
- G0471 G0471 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.