New HCPCS Modifiers – XE, XP, XS, and XU

Four new HCPCS modifiers have been established for claims with dates of service on or after January 1, 2015. Use of the new modifiers is currently optional; however, you may choose to use them to specify more clearly the clinical situations in which Modifier 59 is reported.

• XE – Separate encounter: a service that is distinct because it occurred during a separate encounter
• XP – Separate practitioner: a service that is distinct because it was performed by a different practitioner
• XS – Separate structure: a service that is distinct because it was performed on a separate organ / structure
• XU – Unusual non-overlapping service: the use of a service that is distinct because it does not overlap usual components of the main service

These modifiers may be used for clinical situations in which 2 HCPCS/CPT codes are reported by the same provider on the same date of service and that are currently indicated by appending Modifier 59 (Distinct Procedural Service) to a HCPCS/CPT code. The use of one of these modifiers replaces the use of Modifier 59 on a line item.  Modifier 59 remains a valid PTP-associated modifier.