CPT Coding Tutorial — When Modifier 59 Meets XE, XP, XS, XU (X EPSU)

CPT Coding Tutorial — When Modifier 59 Meets XE, XP, XS, XU (X-EPSU) https://www.cco.us/ceu-on-demand-classes-modifiers-yt

Laureen: Alright, so our first question, we’re going to open up the line for Jo-Anne, she is one of our instructors and she’s recently increased her time with us, we’re very excited. Jo-Anne, can you hear us? Or can we hear you?

Jo-Anne: Yes, I can. Can you hear me?

Laureen: We can. And if you can hit your little camera button, so that we can see your lovely face. There you go!

Alicia: There she is.

Laureen: So, can you see your slide, to go ahead and...?

Jo-Anne: Oh yes, OK.

Laureen: OK. You can talk a little bit about yourself, Jo-Anne. I think you came on the webinar once or twice before. You might want to tell the group what courses you teach for CCO?

Jo-Anne: Oh, OK. I teach the coding course, the Physician Practice Manager Course and the ICD-10 Mini Course. So, very involved with that, and the students are great and I think the curriculum is wonderful, so I’m thrilled to be here doing these with you guys.

Laureen: And Jo-Anne’s background, she is being very modest, she’s own and run a very successful billing company that her daughter is now taking over the reins, but she knows a lot about the reimbursement side of this business. So, the Physician Practice Manager Course, we’re very excited to have her in there and improving it with all of her great real world experience.

Jo-Anne: Oh, thank you.

Laureen: So, this question came from a student that – and Jo-Anne had done a blog article on this, I thought this would be a good one for her to go ahead and answer; so take it away Jo-Anne.

Jo-Anne: Modifier 59 Meets XE, XP, XS, XU

Q: I received a notice from AAPC stating that CMS is establishing the following new modifiers (referred to collectively as-X {EPSU} modifiers) to define specific subsets of the 59 modifier.

A: In basic English, picture modifier 59 as an umbrella and the 4 new X modifiers, the HCPCS modifiers, they’re just more selective. Medicare has spent a lot of money overpaying for the misuse of modifier 59, so this is an opportunity for Medicare to have the coders use very specific modifiers to explain the claim form and I like it. It’s just my only concern right now is that Medicare has not come forward with any specific example of how to use these codes. I have talked to other consultants and spoke with Medicare directly because I offered some examples and I just wanted to be sure that we were on the same page but I strongly recommend anyone that’s involved with using these modifiers to monitor with their billing company and see how they are being reimbursed.

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