What are the new X modifiers?
What are the new X modifiers?
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. To start, let’s quickly define the four newest HCPCS modifiers, also commonly referred to as -X{EPSU} modifiers.
What are the X modifiers for Medicare?
Modifiers XE, XS, XP, XU defined XE – “Separate encounter, A service that is distinct because it occurred during a separate encounter” This modifier should only be used to describe separate encounters on the same date of service.
What do the X modifiers mean?
Modifier XE Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate. Encounter. Modifier XS. Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate. Organ/Structure.
What are modifiers Xs and Xu?
Modifier XS Separate structure – A service that is distinct because it was performed on a separate organ/structure. 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.
When should Xu modifier be used?
You may report modifier 59 or –XU for a diagnostic procedure performed before a therapeutic procedure only when the diagnostic procedure is the basis for performing the therapeutic procedure.
When should modifier Xu be used?
When should modifier Xs be used?
Use of XS modifier. Modifier -XS is a subset of modifier -59. It is used to indicate a procedure should be reported separately with another procedure that it would typically bundle into because it was performed on a separate site.
Can you bill modifier 59 and 51 together?
Never use both modifier 51 and 59 on a single procedure code. If there is a second location procedure (such as a HCPCS code for right or left), use the CPT® modifier first.
Is modifier Xu the same as 59?
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. (Only use modifier 59 if no other more specific modifier is appropriate.)
Can modifier Xu and Xs be used together?
Modifiers XE, XS, XP and XU can be used to identify services that are not normally reported together but are appropriate under certain documented circumstances. Modifiers XE, XS, XP and XU describe specific information and circumstances regarding why two or more services are appropriately reported together.
What is CPT modifier Xu?
HCPCS modifier XU indicates that a service is distinct because it does not overlap usual components of the main service. It is used to note an exception to National Correct Coding Initiative (NCCI) edits.
Can you use two modifiers?
In the case of more than one modifier, you code the “functional” modifier first, and the “informational” modifier second. The distinction between the two is simple: you always want to list the modifiers that most directly affect the reimbursement process first.
Can you use modifier 59 and Xu?
Don’t report the 2 codes together if they’re performed at the same anatomic site and same patient encounter, because they aren’t considered “separate and distinct.” Don’t use modifiers 59 or –XU to bypass a PTP edit based on the 2 codes being “different procedures.” (See example 8 below.)
Can you bill modifier 25 and 59 together?
A: Yes, the BCBSTX Provider website has additional links to support correct claims billing using modifiers 25 and 59. Refer to the General Reimbursement Information under Standards and Requirements. CPT, copyright 2018, by the American Medical Association (AMA). All Rights reserved.
Which modifier goes first TC or 59?
If you code two pricing modifiers that include either a professional or technical component (26 or TC), always use the 26 or TC first, followed by the second pricing modifier. If you have two payment modifiers, for example 51 and 59, enter 59 first and 51 second.
When would you use modifier Xu?
Examples of the appropriate use of modifiers XE, XP, XS, XU, or 59:
| Modifier to use: | Rationale |
|---|---|
| XU versus 59 | Depending upon your specific circumstances XU or 59 may be most appropriate. |
| 59 | Same encounter Same organ system and/or structure (skin) Different lesions. |
What is modifier 77 used for?
CPT modifier 77 is used to report a repeat procedure by another physician. This modifier may be submitted with EKG interpretations or X-rays that require a second interpretation by another physician.
What is the correct modifier?
The service or procedure has both professional and technical components.
What is the XS modifier?
Modifier XS. Definition. Separate Structure, A Service That Is Distinct Because It Was Performed on A Separate Organ/Structure. Appropriate Usage.
What is a FX modifier?
The official publication for Level I HCPCS (CPT-4 codes) for hospital providers
What is an example of modifier?
XE Separate encounter,a service that is distinct because it occurred during a separate encounter
