Wiki Modifier XE

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dmdahlgren

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New coder working through labs. I have 80061 and 83721. My first assumption was to append modifier 59 to 83721 but have been told to use XE instead to bypass edits. Is this correct? I still don't understand how the two modifiers should be used.
 
Hi - There are a few things to look at. Does the payer prefer 59 or X{EPSU}? If they allow, X{EPSU} mods like XE, then that could provide better support for reporting a lipid panel (80061) and LDL (83721) on the same date because you're saying these were separate tests at separate encounters. Medicare NCCI PTP physician edits do allow you to override the 80061/83721 edit with a modifier, but you need to be sure the case meets the requirements for separate reporting. Here are some resources that may help:
 
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