DecisionHealth, DecisionHealth - 2019 Issue 11 (November)

Mind your modifiers: Use examples to improve your X modifier utilization

Medicare does not require practices to use the four modifiers for distinct procedures that it created as alternatives to modifier 59 (Distinct procedural service). However, some private payers want practices to use the more detailed modifiers when appropriate. In addition, a review of the latest data for Medicare Part B claims shows that anesthesia and pain management practices regularly use the modifiers, with modifiers XS (Separate structure) and XU (Unusual non-overlapping service) being the most commonly used modifiers.

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