What are the X modifiers?
Effective January 1, 2015, XE, XS, XP, and XU are valid modifiers. These modifiers give greater reporting specificity in situations where you used modifier 59 previously. Use these modifiers instead of modifier 59 whenever possible.
What is the difference between 59 and Xu modifier?
A. Modifier 59 should not be used when one of the -X{EPSU} modifiers describes the reason for the distinct procedural service. The -X{EPSU} modifiers are more specific versions of the -59 modifier. It is not appropriate to bill both modifier 59 and a -X{EPSU} modifier on the same line.
What is a 52 modifier used for?
Modifier 52 This modifier is used to indicate partial reduction, cancellation or discontinuation of services for which anesthesia is not planned. The modifier provides a means for reporting reduced services without disturbing the identification of the basic service.
What is modifier Xs mean?
separate structure
Two different physicians perform two separate procedures on a patient on the same day. Modifier Code XS. This modifier is used to identify “separate structure, a service that is distinct because it was performed on a separate organ/structure”.
What is modifier Xu mean?
unusual non-overlapping service
HCPCS Modifier XU — unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service. Guidelines and Instructions. HCPCS modifier XU indicates that a service is distinct because it does not overlap usual components of the main service.
What is the purpose of modifiers 73 and 74?
Modifier -73 indicates procedures discontinued prior to anesthesia, whereas modifier -74 is appropriate for procedures discontinued after anesthesia administration or after the procedure has begun (e.g., the physician made the incision or inserted a scope).
When to use Xu instead of modifier 59?
XU – “Unusual Non-Overlapping Service, The use of a service that is distinct because it does not overlap usual components of the main service” Although NCCI will eventually require use of these modifiers rather than modifier 59 with certain edits, you may begin using them for claims with dates of service on or after January 1, 2015.
When to use the-X EPSU modifier in Medicare?
The -X {EPSU} modifiers are essentially a subset of modifier 59. CMS believes their usage will help reduce overpayment errors. Modifier 59 is not going away and will continue to be a valid modifier, according to Medicare. However, modifier 59 should NOT be used when a more appropriate modifier, like a XE, XP, XS or XU modifier, is available.
What are the new Medicare modifiers for 2015?
Proper modifier usage can be one of the biggest hurdles to filing a clean claim. Medicare recently announced they’ve established four new modifiers – XE, XS, XP, and XU – that may be used in lieu of modifier 59. The codes are more specific and become effective January 1, 2015.
Is the Xe modifier recognized by Medicaid and Medicare?
CMS regulates both Medicare and Medicaid and the XE modifier should also be recognized by Medicaid. Check with your local state Medicaid program. A CMS Manual System Transmittal 1422 https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1422OTN.pdf references the use of this particular modifier and recognizes this modifier.
