Q&A: Scenarios for reporting modifier -XU

Q: I know the -X{EPSU} modifiers are not yet required by CMS, but in what instance would 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) be justified instead of modifier -59 (distinct procedural service)?

A: For services that are routinely performed with more major services and that are therefore considered incidental to the more major procedure, modifier -XU may be used to note that the documentation supports that the usually incidental service is indeed separate and distinct from the more major procedure.

For example, an EKG is performed early in an ED visit for chest pain, and subsequent to treatment, a surgery is performed. As long as the EKG was distinct from the surgery and not used for monitoring, modifier -XU may be used.

Editor's note: This question is an excerpt from the newly updated HCPro book "JustCoding's Guide to Modifiers: Hospital Outpatient Edition" by Susan E. Garrison, CHCA, CPC, CPC-H.

This answer was provided based on limited information. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

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