Q&A: -XU modifier circumstances

Q: What are some examples of extenuating circumstances that could be modified with an -XU modifier (unusual nonoverlapping service) if none of the other -X modifiers are applicable?

A: I have not come across anything that I believe specifically meets that definition. I think that when Medicare created the -X modifiers, they might have been thinking that modifier -XU would be the catchall for everything that didn’t meet one of the other three modifier definitions. Part of the reason for coming up with those specific modifiers was that modifier -59 (distinct procedural service) was too broad. But again, we’re waiting for guidance on how CMS wants that modifier to be used.

For more information, see Medicare Billing Edits: A Guide to Regulation, Research, and Resolution.

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