Changes Coming To Usage of Modifier 59

April 1, 2019
Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) has announced a significant change to the use of modifier 59, XE, XP, XS and XU effective July 1, 2019. Currently, the multi-carrier system (MCS) claims system processing logic for modifier 59, XE, XP, XS and XU be appended to the column two CPT code of a procedure to procedure (PTP) edit in order to bypass the edit and allow both CPT codes to be paid by the Medicare Administrative Contractor (MAC).

Beginning with dates of service on and after July 1, 2019, the CMS will

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Click HERE to view the latest NCCI edits. If you would like to read some of my previous articles on the new subsets of modifier 59 (XE, XP, XS, and XU), click HERE.

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