Transcription of Modifiers XE, XS, XP, XU, and 59 - Distinct Procedural Service
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Modifiers XE, XS, XP, XU, and 59 - Distinct Procedural Service
Manual: Reimbursement Policy Policy Title: Modifiers XE, XS, XP, XU, and 59 - Distinct Procedural Service Section: Modifiers Subsection: None Date of Origin: 1/1/2000 Policy Number: RPM027 Last Updated: 10/3/2017 Last Reviewed: 10/18/2018 Scope This policy applies to all Commercial medical plans, Medicare Advantage plans, and Oregon Medicaid/EOCCO plans. Reimbursement Guidelines Effective for dates of Service January 1, 2015 and following, Moda Health will accept Modifiers XE, XS, XP, and XU and will expect providers to use Modifiers XE, XS, XP, and XU in place of modifier 59 when appropriate. Modifier 59 should not be used when one of the -X{EPSU} Modifiers describes the reason for the Distinct Procedural Service . The -X{EPSU} Modifiers are more specific versions of the -59 modifier. It is not appropriate to bill both modifier 59 and a -X{EPSU} modifier on the same line. CPT codes submitted with Modifiers XE, XP, XS, XU, or 59 appended will be considered separately reimbursable when all of the following apply: The clinical edit is eligible for a modifier bypass ( per edit rationale, CCI modifier indicator = 1 , etc.)
Manual: Reimbursement Policy Policy Title: Modifiers XE, XS, XP, XU, and 59 - Distinct Procedural Service Section: Modifiers Subsection: None Date of Origin: 1/1/2000 Policy Number: RPM027
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