BMBankOfMedicare.comBilling University & Reimbursement Research

Modifier 24

Modifier 24 Description and Billing Use

Plain-language description

Reports a separately supported E/M service by the same professional during a postoperative period; verify the current licensed code definition and payer rule.

How modifier 24 is used

Modifier 24 identifies an unrelated evaluation and management service by the same physician or qualified professional during a postoperative period. The record must show why the E/M work is unrelated to the surgery; a different diagnosis by itself may not establish that distinction.

Before reporting this modifier

  1. 1. Confirm the current official or licensed definition and payer acceptance.
  2. 2. Identify the exact claim circumstance the modifier communicates.
  3. 3. Make the code, setting, related services, and medical record consistent.
  4. 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
  5. 5. Do not append a modifier only to force an edit override.
LessonStudy the related billing ruleOfficial sourceReview current CMS guidance

This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.