Wiki New Medicare 59 Subset X {EPSU} Modifiers

[sew1984]

I would like to know if anyone is aware of any upcoming or available webinars on the new -59 subset modifiers that will be implemented in January 2015. My question is not necessarily what they mean, but more, should they be combined with modifier 59, or be used alone?

Any help would be appreciated.

 

[mhstrauss]

I would like to know if anyone is aware of any upcoming or available webinars on the new -59 subset modifiers that will be implemented in January 2015. My question is not necessarily what they mean, but more, should they be combined with modifier 59, or be used alone?

Any help would be appreciated.

Check with your MAC. Mine (Novitas) has one on 12-12-14, and I've seen several others post that their MAC's are doing webinars also. I haven't seen anything yet specifically from CMS or any other resource, will post here if I come across anything.

 

[sew1984]

Thanks!

Thanks Megan. I appreciate your help!

 

[mrsjehu]

You can also check with your State Medical Assoc. I was on a webinar yesterday for the CPT changes for 2015, and they are going to be preparing some material for us once Medicare gets them the information. Everyone is a bit unclear, and I don't know that Medicare has come out with nailed down specifics yet.

 

[ashley.roberts@nchmd.org]

59 Modifier Changes

I attended an AAPC webinar regarding the modifier 59 changes just last week and thought this may be helpful for you:

http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/Downloads/MM8863.pdf

The webinar was not all that informative unfortuantely.

 

[NIENAJADLY]

Use of X(EPSU) modifiers

FYI, I saw on the CMS website that the X modifiers would be used INSTEAD of, not with the -59 modifier.

http://www.cms.gov/Outreach-and-Edu...k-MLN/MLNMattersArticles/downloads/MM8863.pdf

Hope that helps.

 

[honeybee]

I attended a CMS webinar but it was only somewhat helpful and even they didn't know exactly how it will effect different provider specialties at this time. The X mods will be used in place of 59 but not in all circumstances, it will not entirely replace 59 for the CCI edits. CMS could only say that it will be used on "high risk codes" but stated there is no list of the codes they will be asking for the X mods to be used on specifically. Luckily they happened to go over a few PT codes examples so that was helpful in our case to understand that we will most likely need to replace our 59 mods with the XU modifier since we are generally basing the modifier on providing services in non overlapping time frames but we plan on watching for denials in order to identify any issues ASAP given the unknown.

 

[RobynKing]

I have another question from a pathology stand point. XS would be the perfect modifier to use for those cases where they are doing an EGD and a colonoscopy. Or for when they have samples from different areas correct? And, my other question is: is this just for medicare patients or for all patients? Nothing specifies this. Thanks!

 

[Bsutton]

XS modifier and "structure"

I am somewhat confused by the word "structure" in the description for the XS modifier.
Can anyone please help explain what is meant or give me a scenario for what this means?
thanks in advance.

 

[mdmeyer]

I am somewhat confused by the word "structure" in the description for the XS modifier.
Can anyone please help explain what is meant or give me a scenario for what this means?
thanks in advance.

I agree, "structure" is a bit confusing. Modifier 59 used the term "site" which made things more clear... I deal with destruction of lesions, and used -59 when I had same procedure but in different locations on the skin, so different "site" but same "organ or structure". Not sure if -XS is my replacement modifier or if I stick with -59?