Modifier 24 is reported as follows:

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.

The patient’s record must document that the EM service was solely for the treatment of an underlying condition and not for postoperative care.

Example:

The patient is 2 weeks status post laryngectomy for cancer and is seen in the surgeon’s office for EM service to begin chemotherapy for the next 6 weeks. Documentation supports an established visit level 99214.

Code:  99214-24

Do not use modifier 24 if the following circumstances apply:

Surgical complication is considered part of the surgery package so would not qualify.

Wound infection is part of the surgical package.

Patient is admitted to skilled nursing facility for a condition related to the surgery.

If the postoperative period (10 or 90 days) is over, the modifier should not be used.

Modifier 24 should not be used for services rendered on the same day as the procedure.

By Aimee Wilcox, MA, CST, CCS-P