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 E/M code by that physician. It is imperative, so that other specialties may bill their claims for the same E/M code and not receive denials.

Correct Use

  • Append to initial/subsequent E/M codes only
    • 99221 - 99223 (Hospital-Initial)
    • 99231 - 99233 (Hospital-Subsequent)
    • 99291 (Critical Care)
    • 99304 - 99306 (SNF-Initial)
    • 99307 - 99310 (SNF-Subsequent)
  • 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

 

Last Updated Wed, 12 Feb 2020 16:08:57 +0000