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Cognitive Function Intervention CPT Codes

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CPT Codes 97597 and 97598

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CPT Codes 97607 and 97608

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CPT Code 97610

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Online Digital Evaluation Service

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When you see the letter “X” in a new CPT code, this “X” will be replaced by the actual number that is in the CPT code once the American Medical Association (AMA) releases the 2020 CPT codes in early September. The same is true with the letters “NPP” in the 3 new HCPCS codes described above. These letters will be replaced by numbers once the AMA releases the 2020 CPT codes in early September.

2020 Medicare Physician Fee Schedule Conversion Factor

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MIPS 2020

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I hope you found this article informative. To access the proposed rule, click

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Application of Modifier 59 Changing on July 1st

For dates of service on and after July 1, 2019, the Centers for Medicare and Medicaid Services (CMS), as well as UnitedHealthcare (UHC), is changing which CPT code Modifier 59 must be appended to on the claim form in order for both the Column 1 and Column 2 CPT codes to be paid when provided on the same date of service. If you missed my webinar last week on NCCI edits and Modifier 59, click HERE to see the complete webinar description, objectives and to order the recorded version with handouts and Gawenda Seminars & Consulting NCCI edit reference sheet.

Currently, the multi-carrier system (MCS) claims system processing logic for modifier 59, XE, XP, XS and XU be appended to the

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Examples of When to Use Modifier XE

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and not infrequently overrides the edit in the exact circumstance for which the Centers for Medicare and Medicaid Services (CMS) created the edit in the first place. The CMS has established 4 new subsets of modifier 59 to combat the abuse of Modifier 59 and to better understand why providers utilize modifier 59. In this post, I will provide 3 examples of when the XE modifier would be appropriate to use. The definition of Modifier XE is

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