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tci Part B Insider - 2015 Issue 14

Modifier: CMS: 'No Benefit' to Using X{EPSU} Modifiers Over -59 at This Point

Until the agency offers specific advice on how to use the ‘X’ modifiers, you may want to avoid them. CMS created the X{EPSU} modifiers to cut down on overuse of modifier 59—but now the agency is advising practices to stick with 59 for the time being. Background: Last summer, CMS announced that it was debuting four “X” modifiers to use as subsets of modifier 59 (Distinct procedural service). The X modifiers offer increased specificity to describe the circumstances that make your service “distinct,” and are defined as follows: XE: Separate encounter (A service that...

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