tci Medicare Compliance & Reimbursement - 2015 Issue 4

Modifiers: Master Modifier X{EPSU} With These Examples

Choosing an alternative to modifier 59 is now easier. While the Centers for Medicare & Medicaid Services (CMS) has not been particularly forthcoming about how to use Medicare’s new “X{EPSU}” modifiers, the MACs have begun offering case studies to help you understand how to use them. As we reported in Medicare Compliance & Reimbursement, vol. 41, no. 3, WPS Medicare updated its “Modifiers Fact Sheet” to reflect some tips on using the new modifiers, now NGS Medicare and Part B payer Novitas have stepped in with some solid examples, as follows: Modifier XE (Separate encounter): Patient...

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