Wiki Colonoscopies & new CMS modifiers

[kimberliterpstra]

The surgeon performed a colonoscopy with a hot biopsy, a colonoscopy with injection and a colonoscopy with a snare. Prior to 2015, a 59 modifier was used and all three were paid.

All were performed within the terminal ileum; I'm thinking I can't use modifier XS because all three were performed on the same organ/structure.

Modifier XE would not be appropriate, because all three were performed within the same encounter. Modifier XP would not be appropriate, because they were performed by the same provider.

That leaves modifier XU: unusual non-over lapping service, the use of a service that is distinct because it does not overlap usual components of the main service. Would this be the most appropriate modifier to use in this circumstance?

 

[dialabrew]

Coc

I too am struggling with this modifier. I code Outpatient Hospital GIO charts. XS doesn't seem appropriate. I am still using 59 modifier in this instance.