Recently CMS published CCI edits that are effective retroactively to January 1, 2021. These edits significantly reduce the use of the 59, X, XE, XP, XS, and XU modifiers.
Historically, these modifiers have placed a significant burden on practices both clinically and administratively. These are the denials, adjustments, addendums and appeals that are worked day in and day out by our clinical and billing teams to obtain reimbursement for services furnished separately and distinctly.
We are excited to spread the news that Cigna, Aetna and now Humana have followed the course of CMS and have also eliminated the use of the modifiers in coding pairs that will be significant to our industry.
Each insurance company is taking a different route in processing the claims retroactively to January 1, 2021. Read more from the APTA here.
Have questions about your billing or coding? Questions about how to retroactively bill these claims? Let us know- we're here to help!