AI - JE Part B
Modifier AI
Principal Physician of Record
Instructions
This modifier distinguishes the Principal Physician who oversees patient's care when performing evaluation and management (E/M) services and is only appended to an appropriate initial E/M code by that physician. It is imperative only the admitting physician appends modifier AI, allowing other specialties to submit E/M code and not receive denials.
Correct Use
- Append to initial E/M codes only
- 99221 - 99223 (Initial Hospital Inpatient or Observation Care)
- 99304 - 99306 (Initial Nursing Facility Care)
- Only principal physician of record appends to E/M code
Incorrect Use
- Inappropriate for another physician to append (primary or specialty)
Claim Coding Example
| Treatment Description | CPT/Modifier |
|---|---|
| Dr. Medi's Bill Principal physician of record initial inpatient visit | 99222 AI |
| Dr. Care's Bill Another specialty; initial inpatient visit, same day | 99222 |
Resources
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6
- CMS Change Request (CR) 6740
Last Updated $dateUtil.getDate( $modifieddate , "MMM dd , yyyy" , $locale , $tzone )
