# Replacement of -59 with new "X" modifiers



## lcaskew1 (Jan 6, 2015)

Which of the new X modifiers that are replacing modifier 59 would apply to a doctor doing a heart catheterization and stent placement. We used to code the stent with the location modifier followed by the cath code with modifier -26-59.


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## Chlrtrep (Jan 6, 2015)

I attended a Medtronic Cardiovascular reimbursement seminar in Dec. and their coder suggested using   " XU ".  She did say that there is no specfic description to define the use in this situation, but suggested it was the best option.  She reminded us the -59 is still accepted for the time being and we might have to wait to see which new modifier would fit this specific situation.  Not sure is that helps just thought I would pass that info along.

charles


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## lcaskew1 (Jan 6, 2015)

Thanks, Charles. That's what I thought. None of the new X codes really applies in this situation. Good to know we can still use -59 for now.


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## TAMMYLS (Jan 8, 2015)

My co worker and I were wondering the same thing.  Thank you for the information Charles.


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## stephanie7480 (Jan 9, 2015)

*What about when 2 major coronary arteries are stented?*

2 major coronary arteries are stented after a diagnostic heart cath.

92928-RC
92928-LM-59 
93459-26-XU (pt has grafts)
Would you replace the 59 with XS or XU
It is the same organ but a seperate structure of the organ . . or is the structure defined as the whole organ. Am I over thinking this?


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## Jess1125 (Jan 9, 2015)

stephanie7480 said:


> 2 major coronary arteries are stented after a diagnostic heart cath.
> 
> 92928-RC
> 92928-LM-59
> ...



Personally when I have cases when more than one artery is stented I DON'T use the -59 modifier and don't have any issues. The vessel modifier should be enough to tell them why the code is being billed again. 

Jessica CPC, CCC


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## kad1961 (Jan 9, 2015)

XS refers to separate structure/organ


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## bennieyoung (Jan 22, 2015)

Do you know which modifier would apply if one doctor did the Cath and a different doctor in the same practice did the Stent?  I'm torn between the XP and the XU.  Not sure which one to use.  Any suggestions?


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## cgracehappens (Jan 30, 2015)

*Colonoscopy and the use of the X modifier*

Could anyone help me understand what X modifier I would use when billing a colonoscopy where several biopsies were retrieved by different procedures: ex: 45385, 45380-59, these are all done in the colon at different sites.  thanks for any guidance.


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## bhargavi (Feb 3, 2015)

bennieyoung said:


> Do you know which modifier would apply if one doctor did the Cath and a different doctor in the same practice did the Stent?  I'm torn between the XP and the XU.  Not sure which one to use.  Any suggestions?



i been using xp and it works usually no denials


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