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Placing a separate procedure modifier on the first of the two codes bundled on the claims appears awkward and, as a result, the biller tends to put modifier 59, xe, xs, xp, or xu on the bundled cpt® appearing lower in the claim She is under the impression that the xs. The centers for medicare & medicaid services (cms) issued a policy change modification to the claims processing logic for modifier 59 distinct cms issued transmittal 2259, a modification to the claims processing logic for modifiers 59, xe, xs, xp and xu, on february 15, 2019.
The 30220 would get the xs modifier since it is the column 2 code I have been using the pt/xs combination on medicare and some commercial and my coworker has been using the pt/59 combination on commercial Another example of the xs modifier can be found in my favorite specialty, otolaryngology
The surgeon often performs one procedure in the left sinuses and a bundled service (component code) in the right sinuses (or visa versa).
Always add 26 before any other modifier. If you have two payment modifiers, a common one is 51 and 59, enter 59 in the first position If 51 and 78, enter 78 in the first position Use modifier x series for 59 medicare was concerned that providers was submitting the 59 modifier too often, just adding it when they felt they did not like the fact that two codes were bundled, and used the 59 modifier to get the two codes unbundled and paid.
Modifier 59 is used to identify procedures/services that are commonly bundled together but are appropriate to report separately under some circumstances I would use the xs modifier. This article will teach you how to distinguish between, and properly use, three payment modifiers You can bill 45380 and 45385 when biopsy and lesion/polyp removal performed at different sites of the cololn (eg
Biopsy at ascending colon, polyp removal at descending colon) with an appropriate modifier 59 (before 2014) or xs (from 2015 onwards).
If an insurance requires the pt modifier for a screening colonoscopy that turns therapeutic would it be appropriate to use the xs modifier if two polyp removal techniques are used or would you use the 59 modifier
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