we've been using the new modifiers for all payers since the beginning of the year. Medicare has paid the claims appropriately while our commercial payers and Medicaid has held off until mid-February before they started accepting them. Our MAC is Noridian if that helps. the easiest solution may be to rebill all the denials with modifier 59 and send test claims with an X- every week or so to see when they start accepting them.I code Same Day Surgeries in a small hospital. I just learned today that our billing office is getting denials from medicare claims that have any of the X- mods appened to CPT codes. Is anyone else having this problem?