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AI modifier

George Posted Thu 16th of November, 2017 17:26:14 PM
During hospital visits when is it appropriate to use the -AI modifier?
SuperCoder Answered Fri 17th of November, 2017 01:16:06 AM

As per CMS, the principal physician of record will append modifier “-AI” Principal Physician of Record, to the E/M code when billed. This modifier will identify the physician who oversees the patient’s care from all other physicians who may be furnishing specialty care. All other physicians who perform an initial evaluation on this patient shall bill only the E/M code for the complexity level performed.


Appropriate Usage of -AI Modifier

• To identify the admitting or attending physician who oversees the patient’s care while in an inpatient or nursing facility setting
• Appended to the initial inpatient hospital visit procedure code
• Appended to the initial nursing facility procedure code
• Valid for services January 1, 2010 and after

Inappropriate Usage of -AI Modifier

• Appended to procedure codes other than the initial inpatient visit or initial nursing facility care services
• Appended by physicians other than the attending or admitting physician who oversees the patient’s care
• Appended to services dated December 31, 2009 and before

Note: The primary purpose of this modifier is to identify the principal physician of record on the initial hospital and nursing home visit codes.

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