Do you use Modifier AI when billing Medicare?

 

Modifier AI is used to identify the principal physician of record. It is an informational modifier.

Appropriate Use

To identify admitting or attending physician who oversees the patient’s care during a hospital admission;
Admitting physician appends to the initial inpatient hospital care evaluation and management service (99221-99223);
Admitting physician appends to the initial nursing facility evaluation and management service (99304-99306); and
Append after payment modifiers

Inappropriate Use

Reported by any physician other than attending or admitting physician who oversees the patient’s care during the hospital, or nursing home admission; and
Reported on procedures codes other than 99221-99223 and 99304-99306

References

Centers for Medicare & Medicaid Services Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Sections 30.6.9 F & 30.6.13 A
Medicare Learning Network (MLN) Matters Article, MM6740 - Revisions to Consultation Services Payment Policy
MLN Matters Special Edition, SE1010 - Questions and Answers on Reporting Physician Consultation Service

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