HAP Radiology Billing and Coding Blog

Is Your Radiology Practice Ready for the New HCPCS Modifiers?

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.

Categories: radiology billing, medicare, radiology coding, medicare reimbursement, modifier -59, mppr, X{EPSU} Modifiers, cms

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