Billing Beat

Implementation of professional reimbursement claims editing {X, EPSU modifiers}

December 30, 2015

In the Network Update Special Edition, posted June 11, 2015, Anthem stated they would phase in claim editing systems such as McKesson Inc.’s ClaimsXten along with another proprietary editing system that will automatically apply new or existing edits. The Health Plan will begin phasing in the editing systems starting December 11, 2015 through December 13, 2015. At that time they will accept the new 2015 modifiers XE, XP, XS, and XU. These modifiers will be treated the same as Modifier 59 with dates of service on or after January 1, 2015.

Source: https://www.anthem.com/provider/noapplication/f1/s0/t0/pw_e241838.pdf?refer=ahpprovider&state=oh

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