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CPT Modifier · E/M

Modifier 24

Unrelated E/M service by the same physician during a post-operative period

✅ When to Use Modifier 24

When an E/M service for a problem UNRELATED to the original surgery is provided during the global post-op period.

⛔ When NOT to Use Modifier 24

Do NOT use for routine post-op follow-up visits — those are included in the surgical package.

📋 Documentation Requirements

Document the unrelated diagnosis and that it is not related to the surgical procedure.

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Coding Tips for Modifier 24

Real-world specialist guidance from the PayerReady Medical Coding Team, including audit triggers, denial patterns, and payer policy variations.

Unrelated E/M during a global period. The diagnosis on the E/M claim must be different from the diagnosis on the original surgical claim, otherwise expect bundling denial. Document the new problem clearly, do not chart it as a routine post-op visit.

Modifier 24 FAQ

What does modifier 24 mean? +

Unrelated E/M service by the same physician during a post-operative period

When should I use modifier 24? +

When an E/M service for a problem UNRELATED to the original surgery is provided during the global post-op period.

When should I NOT use modifier 24? +

Do NOT use for routine post-op follow-up visits — those are included in the surgical package.

What documentation is required for modifier 24? +

Document the unrelated diagnosis and that it is not related to the surgical procedure.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on July 16, 2026.

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