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Wiki Medicare Modifier Replacements for 59
- Thread starter bbooks
- Start date
balamuruganm
Guru
CMS Introduces Four New Modifiers in Lieu of Modifier 59
FYR..
subsets of the -59 modifier:
XE Separate Encounter: A service that is distinct because it occurred during a separate encounter
XS Separate Structure: A service that is distinct because it was performed on a separate organ/structure
XP Separate Practitioner: A service that is distinct because it was performed by a different practitioner
XU Unusual Non-Overlapping Service: The use of a service that is distinct because it does not overlap usual components of the main service
Regards,
Balamurugan
FYR..
subsets of the -59 modifier:
XE Separate Encounter: A service that is distinct because it occurred during a separate encounter
XS Separate Structure: A service that is distinct because it was performed on a separate organ/structure
XP Separate Practitioner: A service that is distinct because it was performed by a different practitioner
XU Unusual Non-Overlapping Service: The use of a service that is distinct because it does not overlap usual components of the main service
Regards,
Balamurugan
Here is our first crack at a short list of examples - gleaned from a variety of web sites and our common situations in which we currently us -59.
XE A service that is distinct because it occurred during a separate encounter.
Special stains (e.g. 88342-XE, 88312-XE) with a consult (88323)
Duplicate tests on the same day e.g. clinical lab tests or 88305-XE when referring derm provider also performed 88305 in his/her office.
88305-XE with a consult (88321 or 88323)
XS A service that is distinct because it was performed on a separate organ or structure.
One specimen is examined intraoperatively via touch prep (88333-XS), but a separate specimen is reported intraoperatively via frozen section (88331).
XP A service that is distinct because it was performed by a different practitioner.
XU A service that is distinct because it does not overlap usual components of the main service.
88342-XU, 88441-XU when IHC is performed the same day a flow cytometry (88184-88189)
88342-XU, 88441-XU when also performed with 88360.
Thoughts? Additions?
XE A service that is distinct because it occurred during a separate encounter.
Special stains (e.g. 88342-XE, 88312-XE) with a consult (88323)
Duplicate tests on the same day e.g. clinical lab tests or 88305-XE when referring derm provider also performed 88305 in his/her office.
88305-XE with a consult (88321 or 88323)
XS A service that is distinct because it was performed on a separate organ or structure.
One specimen is examined intraoperatively via touch prep (88333-XS), but a separate specimen is reported intraoperatively via frozen section (88331).
XP A service that is distinct because it was performed by a different practitioner.
XU A service that is distinct because it does not overlap usual components of the main service.
88342-XU, 88441-XU when IHC is performed the same day a flow cytometry (88184-88189)
88342-XU, 88441-XU when also performed with 88360.
Thoughts? Additions?
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