2015 Useful New Modifiers for Physical Therapy Billing and Coding
Beginning January 1, 2015 – CMS had developed 4 new Modifiers that can be useful for therapy service provider. As a consultant helping many of my therapy service provider-clients, I think this could would be more appropriate to use than the modifier 59
These new modifiers are subsets of Modifier 59
For example, using modifier XS when you are treating a patient with two different anatomic site (knee, and back) … this is an appropriate modifier to use.
97110 – (DX Pointer- Code V43.65, 717.9)
97110 – XS (DX Pointer- Code 724.4)
Say hello to your 2015 Useful New Modifiers for Physical Therapy Billing and Coding
Modifier XE Separate encounter: A service that is distinct because it occurred during a separate encounter
Modifier XP Separate practitioner: A service that is distinct because it was performed by a different
Modifier XS Separate structure: A service that is distinct because it was performed on a separate organ/structure
Modifier XU Unusual non-overlapping service: The use of a service that is distinct because it does not overlap usual components of the main service
Although, CMS will continue to recognize Modifier -59 but you have to make sure you will only utilize modifier 59 when there is no other specific modifier that may describe your “distinct” procedure service. When using this modifier, Medical Documentation is vital and essential to support medical necessity. This must be well-documented on the patient’s medical record.