Wiki X (EPSU) Modifiers

[melissa.reed22]

I was told recently that the X modifiers were no longer required by Medicare, and that we should be using 59 modifiers instead. I had not previously heard this and can't find any documentation to support this. Has anyone else heard anything about this?

 

[thomas7331]

There was guidance issued by Medicare on May 15, 2015 in MLM MM8863 that states: "CMS will continue to recognize the -59 modifier, but notes that Current Procedural Terminology (CPT) instructions state that the -59 modifier should not be used when a more descriptive modifier is available." My interpretation has been that the X modifiers should be used unless none of them appropriately reports the reason the code pair should be unbundled, in which case the -59 modifier should be used as a modifier of last resort. I've been waiting for more guidance on these new modifiers, so if anyone is aware of something more current, please let us know.