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Wiki separate distinct procedure-which x modifier?

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PKOHUT

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Local Chapter Officer
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Regarding the X(ESPU) modifiers:
Question 1: Which modifier would I use for separate distinct procedure,ie: 63047-x?, 22630 as well as 73560-x?, 73565 ?
Question 2: Which X modifier explains a separate incision /excision?

The new modifiers with description are:

XE Separate Encounter[/b], 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 separate practitioner

XU Unusual Non-Overlapping Service, the use of a service this is distinct because it does not overlap usual components of the main service.

Thank you for your help in advance!
 
I'll try to answer these the best I can without seeing or knowing what is exactly in the report or patient's chart that you are referring to. Hope this helps and doesn't confuse you more. :-)

Question 1: If I'm not mistaken, 63047 is for a single vertebral segment and would not have an X modifier on it. Any additional vertebral segments would be coded with 63048 and depending on how many additional segments were done would have the XS modifier added for separate structure. Same with 22630. It represents a single interspace and the add on code 22632 would represent any additions interspaces. 73560 (X-ray of knee), I would not use an X modifier, but LT or RT would be more appropriate. If done twice on the same day on the same knee, I would use either the LT or RT followed by XE for separate encounter or XP for separate practitioner. Verify the times the X-rays were taken first to be sure they are in fact separate encounters. For 73565, this is an x-ray of both knees anyway. So unless 2 were done at totally separate times of the day, the only X modifier applicable is XE for separate encounter or XP for separate practitioner.

Question 2: XS for separate structure (or site) would represent separate incision/excision.
 
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