# Xu modifier



## GENOWAL (Jan 16, 2015)

I have a question on the usage of the XU-modifier.  I received some information that states you are to use this modifier when 2 separate lesions are excised separately but are within the same code set.  Are any clinics out there using this when billing multiple excisions or shaves such as 11400-11403 or 11305-11308?


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## CatchTheWind (Jan 20, 2015)

XU would not be the correct modifier in this case.  I would use XS if your carrier accepts the new modifiers*.  Here are their descriptions:

? XE Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter
? XS Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate Organ/Structure [I assume this also means separate site]
? XP Separate Practitioner, A Service That Is Distinct Because It Was Performed By A Different Practitioner
? XU Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service

*Our research has indicated that all the major carriers except some BCBS plans will accept them.


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## Texascoder64 (Jan 20, 2015)

is XS used in place of 59 modifier or is it used additionally to the 59 where applicable?
I called Novitas and they said they will accept these new modifiers, but at this time is not mandatory. 
Thank you


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## CatchTheWind (Jan 21, 2015)

It is used instead of 59.


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## CBSBOOKKEEPING (Jan 28, 2015)

*Carol f, cpc*

I do pain management billing,  when 27096 and 20610 are performed on the same session I have used 59 for 20610-  should I use XS


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## b.knapp@proliancesurgeons.com (Feb 3, 2015)

? XU Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service
 can you expand on this? i'm trying to grasp the difference between XU and XS and how it would apply to Ortho.  For example the Wrist/Ankle or Hip/Shoulder fracture patients we see all the time? Would we be using the XU or XS? if XS why not XU? :-S


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## CatchTheWind (Feb 3, 2015)

No one can expand on this.  Not even CMS.  When experts have asked them to do so, they have not been able to do so.


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