New NCCI-Associated Modifiers (X- EPSU)

Medi-Cal is recognizing the new CMS subset modifiers (X- EPSU) as of January 1, 2015. Medi-Cal will continue to allow modifier 59 to be billed, but only when no other descriptive modifier is available. Providers should use one of the new modifiers, instead of modifier 59, if the clinical situation described by one of the new modifiers is present. Failure to use the appropriate modifier may result in the denial of claims.