What Is Modifier 24?
Modifier 24 is appended to an E/M code to indicate an unrelated evaluation and management service provided by the same physician during the global postoperative period of a procedure.
- When a patient presents during the global period for an unrelated issue, code the E/M with Modifier 24 and link to the unrelated diagnosis (different ICD-10 from the surgical one).
- The encounter note should clearly document the unrelated nature of the visit.
Modifier 24
Also known as: Unrelated E/M Service During Postoperative Period; CPT Modifier 24
Modifier 24 is appended to an E/M code to indicate an unrelated evaluation and management service provided by the same physician during the global postoperative period of a procedure.
Definition
Per AMA CPT, Modifier 24 indicates that an E/M service performed during the postoperative period of a procedure was for a reason unrelated to the original procedure. Procedures with global periods (typically 0, 10, or 90 days for major surgeries) include all related E/M services in the global package; visits during this window for the post-op condition are not separately payable. Modifier 24 unbundles an unrelated E/M service so it can be billed separately. Documentation must support that the E/M addressed a condition unrelated to the original procedure.
Example
A patient is 30 days post-op from a knee arthroscopy (CPT 29881, 90-day global period) and presents to the orthopedic surgeon for a new wrist injury after a fall. The wrist evaluation is unrelated to the knee procedure — bill the E/M (CPT 99213) with Modifier 24 to separate it from the global package.
Common Misconceptions
Modifier 24 only applies during the global postoperative period — outside the global window, no modifier is needed. The diagnosis code on the E/M should clearly differ from the surgical diagnosis to support the 'unrelated' claim.
Practical Application
When a patient presents during the global period for an unrelated issue, code the E/M with Modifier 24 and link to the unrelated diagnosis (different ICD-10 from the surgical one). The encounter note should clearly document the unrelated nature of the visit.
Related Terms
Modifier 25
Modifier 25, defined by the AMA CPT, indicates a significant, separately identifiable evaluation and management (E/M) service performed by the same physician on the same day as another procedure or other service.
Read definition arrow_forwardModifier 79
Modifier 79 is appended to a procedure code to indicate an unrelated procedure or service by the same physician during the global postoperative period of an earlier procedure, separating the new procedure from the earlier surgery's global package.
Read definition arrow_forwardModifier 78
Modifier 78 is appended to a procedure code to indicate an unplanned return to the operating or procedure room by the same physician for a related procedure during the global postoperative period of the original surgery.
Read definition arrow_forwardCPT (Current Procedural Terminology)
CPT is the five-digit procedural code set developed and maintained by the American Medical Association that describes medical, surgical, and diagnostic services performed by physicians and qualified health professionals; it is HIPAA-named for use in claims.
Read definition arrow_forwardWhere This Applies on MedPrecision
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