CommercialBilling CodesMedium impact
03.00.15p, Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
Independence Blue Cross·Coding
Effective date
Mar 5, 2025
We identified it
Jun 19, 2026
Summary
This policy reissue clarifies the correct application of CPT Modifier 24 for billing unrelated E/M services provided by the same physician during a patient's postoperative period. The policy ensures that practices properly distinguish between related postoperative care (which bundles into the global surgical package) and unrelated E/M services (which can be billed separately with Modifier 24). This is a coding clarification rather than a new restriction.
Action Required
By March 5, 2025: Billing team and providers must review policy 03.00.15p to understand proper Modifier 24 application for unrelated E/M services during postoperative periods. Ensure coding staff can distinguish between related postoperative care (non-billable separately) and unrelated E/M visits (billable with Modifier 24). Update internal coding guidelines and training materials to reflect this policy. Providers should document medical necessity clearly when billing unrelated E/M services during global periods. Failure to apply Modifier 24 correctly may result in claim denials or overpayment recovery.