Quick Answer: What Is Modifier Xu?

Is Xu modifier only for Medicare?

However, modifier 59 should NOT be used when a more appropriate modifier, like a XE, XP, XS or XU modifier, is available.

CMS is encouraging providers to adopt the modifiers quickly; they may be used by Medicare and considered valid even before national edits are in place on January 1st..

What does the modifier mean?

A modifier is a code that provides the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code. … Below you will find a brief overview of common modifiers used in medicine.

What is the Xu modifier used for?

HCPCS modifier XU indicates that a service is distinct because it does not overlap usual components of the main service. It is used to note an exception to National Correct Coding Initiative (NCCI) edits. It is effective January 1, 2015.

What is a 25 modifier?

Modifier 25 – this modifier is used to report an Evaluation and Management (E/M) service on a day when another service was provided to the patient by the same physician.

What is a 52 modifier?

Subscribe to APCs Insider! Modifier -52 (reduced services) indicates that a service was partially reduced or eliminated at a physician’s discretion, per the CPT Manual. When a physician performs a bilateral procedure on one side only, append modifier -52.

What is a 95 modifier?

95 Modifier Description The 95 modifier is defined as “synchronous telemedicine service rendered via a real-time audio and video telecommunications system.” In other words, this is a way to describe a Telehealth session.

What is an unbundling modifier?

Modifier 59 Distinct procedural service is an “unbundling modifier.” When properly applied, it allows you to separately report—and to be reimbursed for—two or more procedures that normally would not be billed or paid independently during the same provider/patient encounter.

What is a Hcpcs modifier?

HCPCS modifiers, like CPT modifiers, provide additional information about a procedure or service without redefining the service provided. The hundreds of modifiers established in the HCPCS code set cover everything from a procedure’s Medicare eligibility to.

What is the difference between modifier 59 and Xu?

Reimbursement Guidelines the distinct procedural service. The -X{EPSU} modifiers are more specific versions of the -59 modifier. It is not appropriate to bill both modifier 59 and a -X{EPSU} modifier on the same line.

What is a 56 modifier?

Modifier 56 indicates that a physician or qualified health care professional other than the surgeon performed the preoperative care and evaluation prior to surgery.

What is a 24 modifier?

Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period.

What is a 59 modifier?

The definition of the 59 modifier per the CPT manual is as follows: Modifier 59: “Distinct Procedural Service” – Under certain circumstances, the physician may need to indicate that a procedure or service was distinct or independent from other services performed on the same day.

What is the 58 modifier?

Staged or related procedure or service by the same physician during the postoperative period. Submit CPT modifier 58 to indicate that the performance of a procedure or service during the postoperative period was either: Planned prospectively at the time of the original procedure (staged);

Can modifier 58 be used in the office?

To start, modifier 58 is a surgical-specific modifier, used to indicate a staged or related procedure or service by the same physician during the postoperative period. … Or you need to indicate therapy after a diagnostic surgical procedure.