New Medicare 59 Modifiers

The reference for the information is found at:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1422OTN.pdf 

 
Effective January 1, 2015  -  Medicare has 4 new HCPCS modifiers to define subsets of the modifier 59 "Distinct Procedural Service".  They are:
 
XE Separate Encounter: A service that is distinct because it occurred during a separate encounter.

XP Separate Practitioner: A service that is distinct because it was performed by a different physician.

XS Separate Structure: A service that is distinct because it was performed on a separateorgan/structure.

XU Unusual Non-Overlapping Service: A service that is distinct because it does not overlap usual components of the main service.

 
These new modifiers will more effectively identify distinct services that are typically considered inclusive to another service. Utilizing these modifiers will assist in more accurate coding that better describes the procedural encounter. Do not use one of these modifiers with modifier 59 on the same claim line. According to CPT guidelines, modifier 59 should be used only when no other descriptive modifier explains why distinct procedural circumstances exist.