tci General Surgery Coding Alert - 2020 Issue Q4

Distinct Procedures: Move Surgical Scenarios from 59 to X{EPSU}

Regard NCCI Policy Manual examples. Maybe you’ve recently received a payer notice regarding the use of modifier 59 (Distinct procedure service) or one of the X{EPSU} modifiers. If so, your general surgery practice may not be alone. Read on for a refresher on how and when to use these modifiers, and for highlights of National Correct Coding Initiative (NCCI) 2020 Policy Manual changes that shed some light on the subject. Remember 59 and X{EPSU} Basics Frequent modifier 59 misuse propelled CMS in 2015 to create the following four new, more-precise modifier options, known as the “X{EPSU}” modifiers...

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