Modifier 24 can be appended when a health provider performs an additional unrelated E/M service during surgery. Below are the description and billing guidelines for this modifier.
What Is Modifier 24?
Report modifier 24 only if the E/M service meets the following criteria:
- The patient’s diagnosis documented must meet the medical necessity for the visit.
- The current E/M service is unrelated to the previous procedure.
- The E/M service occurs during the postoperative period of another procedural code.
- The same physician (tax ID or same group and specialty) who performed the previous procedure provides the E/M.
Modifier 24 is officially described by the CPTs manual as: “Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period.”
Sometimes a physician examines a patient within the 90–day global period of a significant procedure but for a different problem.
When the patient has an E/M service with the provider for a postoperative visit, and the provider uncovers another unrelated problem during the visit, you can assign the no–charge CPT code 99024 for the postoperative visit and an E/M code with modifier 24 for the unrelated problem.
CPT 92002 to CPT 92014 (General ophthalmological services) are E/M services. Modifier 24 can be used for these services when applicable.
A physician operated on the patient’s anus. Then, a month later, she sees the patient for a stomach problem.
Bill modifier 24 in this case.
Go back to the complete list of CPT modifiers.