Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period. Medicare defines same physician as physicians in the same group practice who are of the same specialty.
For example, a patient had cataract surgery on the right eye in August 2021. The procedure has a 90 day global period, so all visits relating to the cataract surgery are included in the surgery payment. In September 2021, the patient returns to have a cyst looked at in the left eye. Report the E&M code with modifier -24 attached to the exam with the diagnosis for the cyst as the reason for the exam.
It’s better to be conservative in using modifier -24. Another thing to note: do not use modifier – 24 for the removal of sutures. Suture removal is included in the procedure payment.
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