Radiology Coding Alert

Question: I’ve only been coding in radiology for a few months and I’m having a hard time understanding how to correctly apply the X{EPSU} modifiers on my claims. I’m tired of seeing claim denials for misusing these modifiers — are you able to help?

Montana Subscriber

Answer: X{EPSU} modifiers, especially modifier XE (Separate encounter, a service that is distinct because it occurred during a separate encounter), are used very heavily in radiology as it’s common for a technician to perform one set of X-rays early in the day, then have to bring the patient back for another set later on and bundle them together on one claim.

The other X{EPSU} modifiers are as follows:

• XP (Separate practitioner, a service that is distinct because it was performed by a different practitioner)
• XS (Separate structure, a service that is distinct because it was performed on a separate organ/structure)
• XU (Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service)

Tip: It may also be helpful to think of the “X” as an abbreviation for “exception” and the letter following as the reason for the exception when using these modifiers.

Lindsey Bush, BA, MA, CPC, Production Editor, AAPC