New modifiers XE, XP, XS and XU effective January 1, 2015

Effective January 1, 2015, CMS is adding four new HCPCS modifiers to selectively identify subsets of modifier 59 for Distinct Procedural Services as follows:

• 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

Anthem and our affiliate HealthKeepers, Inc. will accept the new modifiers for claims processed on or after January 1, 2015. However, for commercial lines of business only, and until further notice, the modifiers will be treated as informational only and will not override any claim edits unless they are accompanied with modifier 59. For commercial lines of business, continue using modifier 59 to report distinct procedural services. A separate communication will be sent later for our government lines of business (such as Medicare Advantage, Medicaid and the Medicare-Medicaid Plan) regarding the preceding modifiers.