Question:
The surgeon performs a mastectomy. The patient returns for a post-op E&M within the global period, and the surgeon discusses the need for chemotherapy treatment with the patient. The surgeon will not be managing the chemotherapy. Can the surgeon submit an E&M with modifier 24?
Answer:
CMS states that “underlying condition treatment or an added treatment course that’s not part of the normal surgery recovery” is not included in the global surgery payment. To utilize modifier 24 the documentation must clearly identify that the E/M is unrelated to the procedure. However, if this is a “routine” conversation that typically occurs during the surgeon’s standard post-operative visits, a separate E/M service should not be reported.
*This response is based on the best information available as of 10/15/26.
