CMS States to Keep Using Modifier 59

March 8, 2015
Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) has issued additional guidance regarding the new subsets of modifier 59 (i.e. XE, XP, XS, and XU) that became effective January 1, 2015 and the continued use of modifier 59 after January 1, 2015. In the updated guidance, CMS states providers may continue to use modifier 59 after January 1, 2015 in any instance in which it was correctly used prior to January 1, 2015. Additional guidance and education as to the appropriate use of the new modifiers will be forthcoming as CMS continues to introduce the modifiers in a gradual and controlled fashion. That guidance will include additional descriptive information about the new modifiers. CMS will identify situations in which a specific modifier will be required and will publish specific guidance before implementing edits or audits. To access the CMS document, Gold Members log in or become a Gold member and click

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