A.I.

Up until this week, those two letters stood for a number of different things. Being from Philadelphia, A. I. stood for Allen Iverson for a period of time to any basketball fan (I hear he’s back, but I’m a hockey fan, so let’s move on). In the scientific world, A.I. stands for artificial intelligence. In the case of my one brother, A.I. most often stands for alleged intelligence. Maybe the reader knows a few that I left off this short list.

Beginning on January 1, 2010, the letters “AI” represent a new modifier which stands for “Primary physician of record”.

With the impending elimination of inpatient consultation codes to choose from, physicians once designated as “consultants” will now be utilizing CPT codes 99221-99223 for their first encounter with the patient in the hospital setting in the same way that the admitting physician does currently. With this change comes a need to differentiate between the admitting physician coordinating care and other physicians participating in the care of the patient. Medicare has decided that the best way to do this is for the admitting physician to include a modifier on the charge for the initial encounter. The modifier they have created for this purpose is -AI.

The -AI modifier will be used only by the admitting physician, and only on their initial encounter with the patient in the inpatient setting. In addition, this modifier is to be used for the admitting/primary physician of record for patients admitted to nursing facilities.

According to CMS in Transmittal 1875 announcing the new modifier, if the -AI modifier is mistakenly included by the primary physician on subsequent facility services, the provider will not be penalized with a denial. In spite of this, it is not recommended that the modifier be used in this fashion.

6:50 am, December 18th, 2009 |