XP - JE Part A
Modifier XP
Definition
Separate Practitioner, A Service That Is Distinct Because It Was Performed By A Different Practitioner
Appropriate Usage
- Append when coding pairs are part of National Correct Coding Initiative (NCCI) procedure to procedure edits
- Append when documentation indicates services were provided by different practitioners with same specialty in same group practice
- Append to Column 2 procedure code in NCCI files
- Append only when there is no other modifier to describe situation
Inappropriate Usage
- Appending when code pairs are not part of NCCI procedure to procedure edits
- Appending if another valid modifier exists to identify performance of services by different practitioners
- Submission of E/M Codes
- Submission of Weekly radiation therapy management codes (CPT 77427)
- Appending when NCCI code files show modifier application as "0"
- Appending when documentation does not support services were provided by different practitioners
- Exact same procedure code performed twice on same day
- Multiple administration of injections of same drug
- Submitted with Modifier 59