Urology Coding Alert

Question: The physician ordered a urine culture and an expressed prostatic secretions, EPS, culture during the same session, which we think should be coded as 87086 and 87070. Should we include an XU modifier on 87070? I have tried the XS modifier, and Medicare denies the 87070.

North Carolina Subscriber

Answer: Based on the information you share, it seems appropriate to append modifier XU (Unusual non-overlapping service) to 87070 (Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates) for the EPS culture you performed. Since your insurer denied code 87070 with modifier XU, you may want to try appending modifier 59 (Distinct procedural service), depending upon the details of this case.

Code 87086 (Culture, bacterial; quantitative colony count, urine) will not need a modifier.