Modifier 59 vs 25


Due to perceived overuse of the “59” modifier, CMS developed 4 new modifiers which took effect January 1, 2015. These modifiers include: XS, XP, XU, and XE, and can all potentially be used in place of the “59” modifier. CMS states anytime 1 of these 4 modifiers can be used, it should be used over the “59” modifier. Reporting Hospital Outpatient Modifiers ... 25 27 The new definition stated that, unlike modifier -59, modifier -51 could not be appended to designated "add-on" codes, in other words, codes that are bundled. Modifier -59 was designed to unbundle codes when the procedures were distinctly separate. Modifier -59 is appended solely to surgery procedure codes. It is never used on E/M codes. Modifiers 59 and 91 with Lab Codes Modifier 59 (distinct) and 91 (repeat) are valid modifiers for most laboratory services and should be used when multiple laboratory services described by a single code are provided to a patient on one day by the same provider. It is important to use the right modifier for the situation. Jan 29, 2018 · Modifier 59 is being used because the right sided BSD, 31296, is being performed on a separate structure, the right sinuses while the combination code, 31298 is being performed on the left side. That means that if this was a Medicare patient, we would use the XS instead of the 59 Modifier to tell Medicare that we are unbundling these two codes ...