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Modifiers That Are Always Required
GN: Speech Therapy
GO: Occupational Therapy
GP: Physical Therapy
Append the KX modifier to all claims above the 2023 KX threshold:
PT + SLP Combined = $2230
OT = $2230
See the KX Modifier page for more details.
Therapy Assistant Modifiers
CO: Outpatient occupational therapy services furnished in whole or in part by an OTA.
CQ: Outpatient physical therapy services furnished in whole or in part by a PTA.
See our CO/CQ guides for more information.
Modifier 59: “Distinct Procedural Service", it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M (Evaluation/Management) services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual.
XE : “Separate Encounter", a service that is distinct because it occurred during a separate encounter. Only use XE to describe separate encounters on the same date of service.
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.
XU: “Unusual Non-Overlapping Service", the use of a service that is distinct because it does not overlap usual components of the main service.
See our NCCI Page for more information.
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