Is Modifier -59 going away?
Written by Editor   
Wednesday, November 26, 2014 01:32 PM

Anyone who uses modifier 59 needs to be aware that due to problems with the incorrect usage of this modifier (which by the way is also revised for 2015,) CMS has added four new HCPCS modifiers. An announcement by CMS stated that "CMS is establishing four new HCPCS modifiers to define subsets of the -59 modifier, a modifier used to define a “Distinct Procedural Service.” 

These new codes are:

  • XE Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter, 
  • XS Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate Organ/Structure
  • XP Separate Practitioner, A Service That Is Distinct Because It Was Performed By A Different Practitioner, and 
  • XU Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service. 
"CMS will continue to recognize the -59 modifier, but notes that Current Procedural Terminology (CPT) instructions state that the -59 modifier should not be used when a more descriptive modifier is available."
CMS recognizes that modifier 59 has the potential for abuse and will be requiring the use of these new modifiers in January. For this reason, it is highly likely that claims reported with modifier 59 will be closely scrutinized.

Source:  http://www.chirocode.com/Is_Modifer-59_going_away