NCCI edits for HCPCS G0428
CMS lists 57 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 109 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 0 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, and it is the Column Two code that is denied while Column One is paid.
- 01250 01250 denies
- 01320 01320 denies
- 01400 01400 denies
- 0213T 0213T denies
- 0216T 0216T denies
- 29874 29874 denies
- 29877 29877 denies
- 36591 36591 denies
- 36592 36592 denies
- 62320 62320 denies
- 62321 62321 denies
- 62322 62322 denies
- 62323 62323 denies
- 62324 62324 denies
- 62325 62325 denies
- 62326 62326 denies
- 62327 62327 denies
- 64400 64400 denies
- 64405 64405 denies
- 64408 64408 denies
- 64415 64415 denies
- 64416 64416 denies
- 64417 64417 denies
- 64418 64418 denies
- 64420 64420 denies
- 64421 64421 denies
- 64425 64425 denies
- 64430 64430 denies
- 64435 64435 denies
- 64445 64445 denies
- 64446 64446 denies
- 64447 64447 denies
- 64448 64448 denies
- 64449 64449 denies
- 64451 64451 denies
- 64461 64461 denies
- 64463 64463 denies
- 64479 64479 denies
- 64483 64483 denies
- 64490 64490 denies
- 64493 64493 denies
- 64505 64505 denies
- 64510 64510 denies
- 64517 64517 denies
- 64520 64520 denies
- 64530 64530 denies
- 69990 69990 denies
- 96523 96523 denies
- 99155 99155 denies
- 99156 99156 denies
Showing 50 of 57. 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.
- 0566T 0566T denies
- 0596T 0596T denies
- 0597T 0597T denies
- 0708T 0708T denies
- 0709T 0709T denies
- 0903T 0903T denies
- 0904T 0904T denies
- 0905T 0905T denies
- 11010 G0428 denies
- 11011 G0428 denies
- 11012 G0428 denies
- 20600 20600 denies
- 20604 20604 denies
- 20605 20605 denies
- 20606 20606 denies
- 20610 20610 denies
- 20611 20611 denies
- 20704 20704 denies
- 27328 G0428 denies
- 27329 G0428 denies
- 27331 G0428 denies
- 27332 G0428 denies
- 27333 G0428 denies
- 27339 G0428 denies
- 27345 G0428 denies
- 27347 27347 denies
- 27364 G0428 denies
- 27403 G0428 denies
- 27437 G0428 denies
- 27438 G0428 denies
- 27440 G0428 denies
- 27441 G0428 denies
- 27442 G0428 denies
- 27443 G0428 denies
- 27446 G0428 denies
- 27447 G0428 denies
- 27455 G0428 denies
- 27486 G0428 denies
- 27487 G0428 denies
- 27570 27570 denies
- 27580 G0428 denies
- 29868 G0428 denies
- 29870 29870 denies
- 29871 29871 denies
- 29875 29875 denies
- 29880 G0428 denies
- 29881 29881 denies
- 29882 29882 denies
- 29883 29883 denies
- 29884 29884 denies
Showing 50 of 109. 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.