Today Medicare denied a claim that we bill on a daily basis. One of the charges had a modifier -59 on it, like we normally put on the combination that we bill.....that charge was denied stating that the -59 was no longer sufficient, that we needed and "X" modifier (this is what our local MAC told us). We were given the information, but the "memo" on it states it's not effective until January 2015. How can they deny a claim for something that hasn't taken effect yet?
These are the modifiers listed on the CMS memo ---- "XE" - separate encounter - a service that is distinct because it happened during a separate encounter; "XS" - separate structure - a service that is distinct because it was performed on a separate organ/structure; "XP" - separate practitioner - a service that is distinct because it was performed by a different practitioner; and "XU" - unusual non-overlapping service - the use of a service that is distinct because it does not overlap usual components of the main service.
Has anyone else Medicare give them this information.......before 3 days ago, we had heard nothing of it.
CONFUSED.......
Jenn