Part B Insider (Multispecialty) Coding Alert
More Modifier X{EPSU} Examples Trickle Forward
Plus: Modifier 90 is not your friend—unless you work at an independent lab.
It could be time to put your X{EPSU} frustrations on the back burner.
As we reported in last week’s issue of the Insider, CMS has been slow to offer examples on how to use Medicare’s new “X{EPSU}” modifiers, but the MACs have been coming forward with case studies that show you how to use them, and this week Part B provider Novitas stepped forward to provide the most comprehensive examples yet.
For example, Novitas suggests that you can scrap using modifiers 59 (Distinct procedural service), LT (Left side) or RT (Right side) if the doctor performs an arthroscopic rotator cuff repair and an arthroscopic partial synovectomy during the same session. Instead, “modifier XE (Separate encounter) may be more appropriate” in this situation, the payer says.
Therefore, you’d report this service using 29827 (Arthroscopy, shoulder, surgical; with rotator cuff repair) followed by 29820-XE (Arthroscopy, shoulder, surgical; synovectomy, partial).
To read Novitas’ complete advice and examples, visit www.novitas-solutions.com.
Part B Insider (Multispecialty) Coding Alert
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