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NCCI Code Pairs — 95875

Complete listing of CMS National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits involving HCPCS/CPT code 95875.

116 Total Edits 94 as Column 1 22 as Column 2
← View HCPCS 95875 Detail Page

Column 1 Pairs 95875 is the primary code

When 95875 is reported as the Column 1 (comprehensive) code, the paired Column 2 code is bundled and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 20 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0708T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
0709T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
96377 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2017-01-01 2199-12-31
96376 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-07-01 2199-12-31
96375 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96360 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96365 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96372 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96374 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
90765 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90774 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
C8952 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2006-12-31
C8950 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2006-12-31
90775 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90760 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90772 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
36410 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2002-10-01 2199-12-31
36000 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2002-10-01 2199-12-31
95860 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2199-12-31
95869 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2199-12-31
Medicare Practitioner — 37 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0708T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
0709T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
96523 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-04-01 2199-12-31
99451 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-01-01 2199-12-31
99452 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-01-01 2199-12-31
J1644 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2017-07-01 2199-12-31
J1642 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2017-07-01 2199-12-31
96377 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2017-01-01 2199-12-31
36592 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2015-10-01 2199-12-31
36591 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2015-10-01 2199-12-31
99449 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99447 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99446 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99448 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
96376 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-07-01 2199-12-31
96374 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96375 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96360 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96365 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
96372 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2009-01-01 2199-12-31
C8952 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2006-12-31
C8950 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2006-12-31
90775 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90774 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90772 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90765 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
90760 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2006-01-01 2008-12-31
G0351 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2005-04-01 2005-12-31
G0353 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2005-04-01 2005-12-31
G0354 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2005-04-01 2005-12-31
G0345 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2005-01-01 2005-12-31
G0347 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2005-01-01 2005-12-31
90780 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2002-10-01 2004-12-31
36000 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2002-10-01 2199-12-31
36410 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2002-10-01 2199-12-31
95860 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2199-12-31
95869 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2199-12-31
Medicaid Facility — 13 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0709T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
0708T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
96377 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2017-01-01 2199-12-31
96375 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96374 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96372 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96376 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
95860 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
36410 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
36000 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96365 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96360 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
95869 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
Medicaid Practitioner — 24 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
0709T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
0708T · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2022-01-01 2199-12-31
96523 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-04-01 2199-12-31
99451 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-01-01 2199-12-31
99452 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2019-01-01 2199-12-31
J1642 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2017-07-01 2199-12-31
J1644 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Misuse of Column Two code with Column One code 2017-07-01 2199-12-31
96377 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2017-01-01 2199-12-31
36592 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2015-10-01 2199-12-31
36591 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2015-10-01 2199-12-31
99449 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99446 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99447 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
99448 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2014-01-01 2199-12-31
96376 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
36410 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
36000 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
95869 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96360 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96365 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96372 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96374 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
96375 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31
95860 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2199-12-31

Column 2 Pairs 95875 is the bundled code

When 95875 is reported as the Column 2 (component) code, it is bundled into the Column 1 comprehensive code and generally not separately payable.

Medicare Facility (Hospital Outpatient) — 8 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
G0453 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
95940 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
96004 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96003 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96000 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96002 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96001 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
95920 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2012-12-31
Medicare Practitioner — 8 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
G0453 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
95940 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
96002 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96004 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96000 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96003 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
96001 · CCI
0 Modifier not allowed — codes cannot be reported together under any circumstances
CPT Manual or CMS manual coding instruction 2002-01-01 2004-12-31
95920 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 1996-01-01 2012-12-31
Medicaid Facility — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
G0453 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
95940 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
95920 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2012-12-31
Medicaid Practitioner — 3 pairs
Paired Code
Mod? Modifier Indicator: 0 = not allowed, 1 = modifier may permit separate reporting, 9 = N/A
Rationale Effective End Date
95940 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
G0453 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2013-01-01 2199-12-31
95920 · CCI
1 Modifier allowed — a NCCI-associated modifier may permit separate reporting
Standards of medical/surgical practice 2010-10-01 2012-12-31

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