Medicare Compliance & Reimbursement - 2021 Issue 11
Reader Questions: Answer These Three Questions for Modifier 24 Use
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Article Overview
This reader Q&A discusses the use of modifier 24 in evaluation and management coding. It is aimed at coding staff and clinicians who need to assess whether an E/M service occurs during a postoperative global period and whether the visit is related or unrelated to prior care. The article presents broad guidance on how to think through the scenario and suggests confirming uncertain cases with the provider or payer.
Why This Topic Matters
Modifier 24 affects how postoperative evaluation and management services are reported and reimbursed. Understanding its scope helps practices separate unrelated visits from routine follow-up and supports cleaner claim submission.
What You Will Learn
- The general purpose of modifier 24 in E/M coding
- How to think about postoperative period considerations
- What broad factors to review when deciding whether a visit may qualify
- When to seek clarification from the provider or payer
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Other qualified health care professionals
Modifiers Discussed
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