Medicare Compliance & Reimbursement - 2015 Issue 14
Modifier: CMS: 'No Benefit' to Using X{EPSU} Modifiers Over -59 at This Point
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Article Overview
This article covers CMS’s introduction of the X{EPSU} modifiers as alternatives related to modifier 59, along with the agency’s later comments about implementation timing and the absence of detailed national instructions. It is relevant to billing and coding professionals who track CMS guidance, claims-edit changes, and modifier policy updates.
Why This Topic Matters
The piece helps readers understand a CMS policy update that may affect how practices monitor modifier guidance and prepare for future claims-edit changes. It is useful for coders, billers, compliance staff, and software/system maintainers who need to stay current on CMS communications.
Article Sections
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Background
Introduces the CMS initiative involving the X{EPSU} modifiers and places it in the context of modifier-related guidance updates.
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CMS Finally Speaks
Summarizes CMS comments from an Open Door Forum about the timing of implementation and the status of future instructions.
What You Will Learn
- The general purpose of the CMS X{EPSU} modifier set
- How CMS framed the timing of broader implementation guidance
- Why the article discusses interim reliance on existing modifier policy
- What types of audiences are affected by the pending guidance update
Who Should Read This
- Medical coders
- Billers
- Compliance staff
- Practice managers
- Revenue cycle teams
- Software and system maintainers
Codes Discussed
Modifiers Discussed
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