Wiki Modifier XU vs 59

[MandyBMC]

Hi all,

Does anyone here have any experience with modifier XU?

One of our providers wants to bill the following:

G0439 Annual Wellness
99202 +25 E&M
G0444 Annual Depression Screening
G0446 Intensive Behavior Therapy Cardio
G0442 Annual Alcohol Screening

We are concerned with using modifier 59 on the last 3 codes. Would XU be one the to use in this situation?

Any insight would be appreciated!

 

[ddavis024]

What is the reason behind the mod 25?
Is that part of the other services?

 

[MandyBMC]

What is the reason behind the mod 25?
Is that part of the other services?

It was a visit that included things beyond the Medicare annual wellness visit and beyond the additional screenings.

 

[AGMoore]

looking at the definition of each modifier and checking CCI edits the XU modifier description seems to fit this situation better than 59.

 

[JulieRamone]

modifier XU

Hi all,

Does anyone here have any experience with modifier XU?

One of our providers wants to bill the following:

G0439 Annual Wellness
99202 +25 E&M
G0444 Annual Depression Screening
G0446 Intensive Behavior Therapy Cardio
G0442 Annual Alcohol Screening

We are concerned with using modifier 59 on the last 3 codes. Would XU be one the to use in this situation?

Any insight would be appreciated!

Hi. Any X modifiers are inappropriate to append to E/M codes, including the G0442-0446 codes as you listed. 24 is incorrect unless it is during a global period and not related. To unbundle as you described I would use modifier 25 on the G codes.

 

[JulieRamone]

Do not use XU

Any X modifiers are inappropriate with E/M or the G codes you gave as examples. Modifier 25 on the G codes you gave as examples would unbundle them.
Thank you.
Julie