modifier 59

Four new HCPCS modifiers will be available for use beginning in 2015, according to a recent announcement by the Centers for Medicare and Medicaid Services (CMS). Known collectively as the –X{EPSU} Modifiers, they will be used to define specific subsets of the CPT Modifier -59 for a “Distinct Procedural Service”. The new modifiers are intended to offer more precise coding options that will allow practices to avoid potential payment delays, audits and reviews associated with modifier -59. CMS says that -59 is the most widely used modifier, covering a wide variety of circumstances such as to identify different encounters, different anatomic sites and distinct services. Because modifier -59 is so broadly defined, it is often used incorrectly and inappropriately.