Wiki Modifier XU only for Medicare

[ibtrazy2u]

In pathology billing, specifically when 88342 and 88341 are billed together, is the XU modifier used only with Medicare patients? (I'm billing MediCAID right now)

Ex: 88342-26 59,XU (procedures done in the hospital setting)
88341-26 59, XU

Thanks for any answers.

 

[psacco]

for what reason are you appending the XU modifier? per medicare, i do not believe they want both a 59 and "x" modifier on the same claim? without knowing why you are appending the XU its hard to know whats going on...

 

[morganingle]

the x modifiers are to be used in place of the 59 modifier

 

[luhre]

Coding/Data Analyst CPC

The new X modifiers were created by CMS for Medicare billing. 59 modifier can still be used . It would be inappropriate to apply both on the same procedure code. Some other payers are excepting the X modifiers but I would not use them without specific instruction from that payor. I do not see an edit on 88341/88342. I do see an edit on 88342 bundled with 88344, in this case modifier 59 only to 88342 as the column 2 code.