tci Outpatient Facility Coding Alert - 2019 Issue Q3

Reader Question: Implement X{EPSU} Payer Rules into Practice Guidelines

Question: Which payers accept the X{EPSU} modifiers? I’ve heard that you should only report them for Medicare Part B patients. Utah Subscriber Answer: The initial creation of the X{EPSU} modifiers did not provide much clarity as to whether coders should exclusively report them for Medicare Part B patients, or if other payers would accept them as well. However, most billing practices (of various specialties) have found in the years following that many payers do, in fact, allow for X{EPSU} modifiers to be appended to their claims. In order to streamline this process in the future, you should make...

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