AI - JF 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 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
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6
- CMS Change Request (CR) 6740
Last Updated Tue, 25 Oct 2022 17:40:44 +0000