Medicare Debuts New Modifiers to Replace 59

Medicare announced last year their intention to replace modifier 59 (Distinct procedural service) in an attempt to decrease the inappropriate usage of this modifier on related procedures. In place of modifier 59, Medicare has announced four new modifiers, including:

XE – Separate Encounter: Distinct service that occurred during a separate encounter

XS – Separate Structure: Distinct service performed on a separate organ/structure

XP – Separate Practitioner: Distinct service performed by a different practitioner

XU – Unusual Non-Overlapping Service: Distinct service that does not overlap the usual components of the main service

As the most common and appropriate use of modifier 59 is to indicate a separate procedure performed on a separate site (for example bunion corrections on both feet), providers will often use modifier XS in place of 59. While Medicare will allow providers to begin using the new modifiers as of January 5th, 2015, they will continue to allow the use of modifier 59 until further notice.

Brandon McCurdy