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

 

Last Updated Dec 09 , 2023