5 Key Takeaways

• 1

  Modifier -24 is used to bill unrelated evaluation and management services during a postoperative period.

• 2

  It applies to services within 10-day and 90-day postoperative periods, including certain ophthalmological services.

• 3

  Inappropriate use of modifier -24 can lead to billing issues, with the Office of Inspector General reporting questionable practices.

• 4

  Documentation must clearly indicate that the visit addresses a billable, unrelated condition, not routine postoperative care.

• 5

  Modifier -24 is relatively uncommon, used in about 2% of ophthalmologists' office visits and 1% of optometrists' visits.