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.
Use modifier 24 with the appropriate level of E/M service for an unrelated E/M service performed beginning the day after the procedure, by the same physician, during the 10- or 90-day global period.
Modifier 24 identifies an unrelated E/M service performed by the same physician during the postoperative global period, which is separately reimbursable.
What Is Modifier 24 and When Do You Use It? Append only to Evaluation and Management (EM) codes. Use only to report an EM service beginning the day after a procedure performed by the same physician during the past 10 or 90 postoperative days.
What Is Modifier 24 and When Do You Use It? - Find-A-Code
In short, modifiers are the essential "fine print" that tells the complete story of a medical service beyond the base CPT code.
Since the URI is a new, unrelated condition during the postoperative period, modifier 24 is appended to the E/M code. If modifier 24 is not appended to the E/M code, it will be denied as included in the global package of the surgery.
To avoid claim denials and future appeals due to incorrect claim submissions, we’re providing guidance on how to properly submit a claim when applying modifier 24.
Modifier 24 is defined as an "unrelated evaluation and management service by the same physician during a postoperative period." In plain terms, it lets you bill separately for E/M visits during a patient's global period when the reason for the visit has nothing to do with their surgery.