New medicare X (EPSU) Modifiers Usage

Hello,

While coding CPT® codes 70551 (MRI Brain) & 70544 (MRA Brain) in the same day, by the same physician, can we use new modifier XE for 70544? Or are we also to include modifier 59 as well?

Thanks for your in-put.

re: New medicare X (EPSU) Modifiers Usage

You cannot use an X modifier and 59 on the same claim, it is one or the other. Using both will trigger an automatic denial.

re: New medicare X (EPSU) Modifiers Usage

If they were done at different sessions yes the XE can be used. 59 and the X modifiers are not to be billed together, it's one or the other. If they were done at the same session then you need medical necessity for billing both.




http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM8863.pdf