Wiki New 59 modifer rules 2015

[Lynda Wetter]

Has everyone seen what they are doing with the 59 modifer?
They are adding 4 more mods to help weed out some inapropriate use.
I personally like this idea. Although it will not stop the abuse of the modifier it may slow the process and find more inaccurate claims.

I tried to attached the MLN update but it wont let me. Here's an attempt at pasting the link.

http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/Downloads/MM8863.pdf

 

[lkfloyd]

the link worked great!, Thank you for sharing

 

[cldavenport]

Yes, I read about this yesterday. I think it's a great idea as Mod 59 tends to be the most overused modifier.

 

[AInch]

Great information. Thanks for sharing.

 

[greatbiller]

Thank you for sharing! I like the idea of having a modifier spelling out the specific circumstance instead of a general "separate service" which is ripe for abuse.

 

[tmrose]

Which X(ESUP) to use for Post op pain procedures

We use mod 59 to unbundle Post Op Pain procedures from Anes CPT codes on same date, would the new XU be the best one as it is not always a different provider?

 

[shellysk8]

What About Lab?

I am wondering which will be appropriate for lab edits. Currently, there are many times where the same CPT is used for different lab tests. It doesn't appear that any of these new modifiers is really accurate for that scenario. Has anyone seen any clarification on these new modifiers?

TIA,
Shelly
Shelly L. Kubacki, CPC, MPA

 

[senpai_j]

Anyone else confused on how XU would be used? The others I get, but not this one. If it's a non-overlapping service, why do you need the modifier?

Just a reminder that 59 isn't going away. Someone asked about lab, and unless XU applies to lab (?), then 59 could still be used .