Optimum Healthcare policy

Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service - Professional

Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service - Professional is a public Optimum Healthcare policy (policy C-09006, effective Jul 1, 2026). It lists 130 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Optimum Healthcare
Policy number
C-09006
Effective
Jul 1, 2026
Line of business
Commercial
States
CA
Source
www.anthem.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Optimum Healthcare policies
01996Policies naming 01996
09006Policies naming 09006
20551Policies naming 20551
20552Policies naming 20552
20553Policies naming 20553
22558Policies naming 22558
22630Policies naming 22630
22633Policies naming 22633
29806Policies naming 29806
29807Policies naming 29807
29819Policies naming 29819
29820Policies naming 29820
29821Policies naming 29821
29822Policies naming 29822
29823Policies naming 29823
29824Policies naming 29824
29825Policies naming 29825
29827Policies naming 29827
29834Policies naming 29834
29835Policies naming 29835
29836Policies naming 29836
29837Policies naming 29837
29838Policies naming 29838
43281Policies naming 43281
43282Policies naming 43282
43283Policies naming 43283
43332Policies naming 43332
43333Policies naming 43333
43644Policies naming 43644
43645Policies naming 43645
43770Policies naming 43770
43771Policies naming 43771
43772Policies naming 43772
43773Policies naming 43773
43774Policies naming 43774
43775Policies naming 43775
43842Policies naming 43842
43843Policies naming 43843
43845Policies naming 43845
43846Policies naming 43846
43847Policies naming 43847
43848Policies naming 43848
43886Policies naming 43886
43887Policies naming 43887
43888Policies naming 43888
58140Policies naming 58140
58145Policies naming 58145
58146Policies naming 58146
58545Policies naming 58545
58546Policies naming 58546
58561Policies naming 58561
58570Policies naming 58570
58571Policies naming 58571
58572Policies naming 58572
58573Policies naming 58573
62320Policies naming 62320
62321Policies naming 62321
62322Policies naming 62322
62323Policies naming 62323
62324Policies naming 62324
62325Policies naming 62325
62326Policies naming 62326
62327Policies naming 62327
63048Policies naming 63048
63081Policies naming 63081
63088Policies naming 63088
63650Policies naming 63650
63655Policies naming 63655
75699Policies naming 75699
76511Policies naming 76511
76513Policies naming 76513
76603Policies naming 76603
76605Policies naming 76605
76707Policies naming 76707
76769Policies naming 76769
76777Policies naming 76777
76814Policies naming 76814
76816Policies naming 76816
76856Policies naming 76856
76858Policies naming 76858
76881Policies naming 76881
76883Policies naming 76883
76942Policies naming 76942
77002Policies naming 77002
77003Policies naming 77003
77012Policies naming 77012
77021Policies naming 77021
78265Policies naming 78265
78830Policies naming 78830
78835Policies naming 78835
80305Policies naming 80305
80307Policies naming 80307
80320Policies naming 80320
80377Policies naming 80377
81000Policies naming 81000
81003Policies naming 81003
81005Policies naming 81005
82542Policies naming 82542
82570Policies naming 82570
83516Policies naming 83516
83520Policies naming 83520
83789Policies naming 83789
83986Policies naming 83986
83992Policies naming 83992
84156Policies naming 84156
84311Policies naming 84311
95951Policies naming 95951
95953Policies naming 95953
95954Policies naming 95954
95956Policies naming 95956
95957Policies naming 95957
96365Policies naming 96365
96369Policies naming 96369
96372Policies naming 96372
96373Policies naming 96373
96374Policies naming 96374
96379Policies naming 96379
99281Policies naming 99281
99285Policies naming 99285
G0138Policies naming G0138
G0480Policies naming G0480
G0481Policies naming G0481
G0482Policies naming G0482
G0483Policies naming G0483
G0659Policies naming G0659
J1202Policies naming J1202
L8679Policies naming L8679
L8680Policies naming L8680
L8687Policies naming L8687
Q3014Policies naming Q3014

All Optimum Healthcare policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.