Medicare AdvantageBilling CodesMedium impact
MA03.009e, Modifier 24: Unrelated Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional During a Postoperative Period
Independence Blue Cross·Orthopedics, General Surgery, Cardiothoracic Surgery +8 more·Coding
Effective date
Mar 5, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA03.009e regarding Modifier 24 for unrelated E&M services during postoperative periods has been reissued. This affects billing for evaluation and management visits that are unrelated to surgical procedures when provided by the same physician during the global surgical period.
Action Required
By March 5, 2025: Billing team must review and verify correct application of Modifier 24 when billing E&M services unrelated to surgery during postoperative periods for Medicare Advantage patients. Ensure billing software and staff training align with updated policy requirements to prevent claim denials.