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ANESTHESIOLOGY MODIFIER 59

Melissa Posted Tue 06th of January, 2015 12:07:36 PM

I work for an anesthesia billing company. Our doctors work in hospitals and surgery centers, but are not considered their employees. My question is regarding the new modifiers, XE, XS, XP, XU, replacing 59 for HCPCS.

We do not do HCPCS billing. So does this mean we continue to use modifier 59 and do not use the new modifiers? That is the way I understand it, but wanted confirmation.

Thanks for your help.

SuperCoder Answered Wed 07th of January, 2015 03:30:58 AM

CMS has defined four new HCPCS modifiers to selectively identify subsets of Distinct Procedural Services (-59 modifier).

CMS will continue to recognize the -59 modifier in many instances but may selectively require a more specific - X{EPSU} modifier for billing
certain codes at high risk for incorrect billing. For example, a particular NCCI PTP code pair may be identified as payable only with the -XE separate encounter modifier but not the -59 or other -X{EPSU} modifiers. The -X{EPSU} modifiers are more selective versions of the -59 modifier so it would be incorrect to include both modifiers on the same line.

HCPCS billing does not effect it. You can use this modifier with CPT codes.

Thanks !!

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