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New Modifier Use

Tammy Posted Thu 12th of February, 2015 11:34:41 AM

During a colonoscopy our physician removed polyps from descending colon with hot snare. Polyps were also removed in the cecum with cold biopsy forceps. Patient has MCARE. Would the correct modifier for the second CPT (45380) be XS or XU. I have used XU on this in the past. Am I wrong?

SuperCoder Answered Thu 12th of February, 2015 19:55:46 PM

Thanks for your question. Medicare will still accept modifier 59 for distinct procedural service but it should not be used when a more specific modifier can apply. For this particular coding scenario, you should use the XU modifier. The XU modifier represents an unusual non-overlapping service. This modifier is used for a service that is distinct because it does not overlap usual components of the main service. See the attached article on the new EPSU modifiers for additional information.

https://www.supercoder.com/coding-newsletters/my-gastroenterology-coding-alert/modifiers-cms-unveils-4-new-modifiers-to-offset-unwarranted-use-of-59-144088-article

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