Modifier AI is used with
the initial inpatient hospital visit codes (99221-99223) as well as initial
nursing facility codes (99304-99306). Effective from 1st Jan
2010.
Modifier AI must be
submitted by the admitting physician for the initial hospital care or initial
nursing facility care.
As per CMS: To
identify the admitting or attending physician who oversees the patient's care
while in an inpatient or nursing facility setting
This is an informational
modifier. Hence append any payment modifier if applicable before the AI
modifier
Note: Effective Jan 1st 2010 Medicare will no longer recognize AMA CPT Consultation
codes (Outpatient 99241- 99245 & Inpatient 99251 – 99255). Instead of using
consultation codes, we have to use appropriate office or inpatient E&M as
alternate codes for the service rendered.
When 2 physicians
providing care to a patient on the same day in inpatient hospital settings, eg:
Provider “A” who is the admitting physician and Provider “B” is doing
consultation on the same day.
As per Medicare guidelines we have to code initial hospital visit (99221-99223)
codes instead of inpatient consultation codes, Since Medicare, don’t pay for
consultation codes. In this scenario, we have to bill 2 initial hospital visit
codes and we have to append modifier "AI" to the admitting physician.