Modifier XU

Definition

Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service

Appropriate Usage

  • Append when coding pairs are part of National Correct Coding Initiative (NCCI) procedure to procedure edits
  • Append when documentation indicates service was not part of usual components of main service
  • Append to Column 2 procedure code in NCCI files
  • Append only when there is no other modifier to describe situation

Inappropriate Usage

  • Code pairs are not part of the NCCI procedure to procedure edits
  • If another valid modifier exists to identify the service does not overlap the usual components of the main service - the column 1 procedure code
  • Submission of E/M Codes
  • Submission of Weekly radiation therapy management codes (CPT 77427)
  • The NCCI code files show the modifier application as "0"
  • Documentation supports the service is a component of the main service
  • Exact same procedure code performed twice on the same day
  • Multiple administration of injections of the same drug
  • Submitted with Modifier 59

Additional Information

 

Last Updated Fri, 28 Feb 2020 13:02:15 +0000