Question RE: The "X" modifiers and surgery

[tammy roach]

I have read so much on the new "X" modifiers but still can not find the answer to my question. Which "X" modifier would you use in a knee or shoulder scope (as an example) say...29827 and 29823,59. Which "X" modifier would you use in that scenario? Or, 29888 and 29881,59?
Thanks so much !!

 

[lmann]

X modifier

According to AMA guidelines XS is the modifier for a separate structure or organ. Hope that helps you. Laurel

 

[tammy roach]

still confused

XS, but its all the "same structure", the shoulder. Or the knee. They really need to clarify this.

 

[vgilbert415]

In your knee scenario you have two separate structures the anterior cruciate ligament, and a meniscus.

 

[dclark7]

In your knee example you would not need any modifier, these codes are not bundled (29881, 29888).

For your shoulder example you could only bill the debridement if it was the opposite shoulder. so no "x" modifier would be used. This is from the NCCI Policy Manual, chapter 4, Musculoskeletal, page IV-6 -

"4. With the exception of the knee joint, arthroscopic debridement should not be reported separately with a surgical arthroscopy procedure when performed on the same joint at the same patient encounter. For knee joint arthroscopic debridement see the following paragraph."

 

[DOVERRED]

I disagree with not able to use 29823(extensive), 29822 debridement(limited) is the code that you can not use on same side with 29827...

 

[marak0829]

Exact definition of structure re: Xs mod

Hello-

Does anyone have any definitive/exact examples of Modifier 59 vs. X modifiers?

Also needing to know what does "Structure" mean in regards to Orthopaedics and Colonoscopies...

Thanks,

Mara (confused,even after Webinars)