Medicare Compliance & Reimbursement

Plus: You no longer need to list the ordering/referring physician as item 17 on your claim form when a 'consult' takes place, since CMS doesn't recognize consults. If you forget to append modifier AI (Principal physician of record) to your initial hospital care claims, you'll still collect your fees, at least from one Medicare payer. That was the word from the Feb. 9, 2010 NGS Medicare Part B Consultation Coding Changes conference call. NGS, which is the Part B MAC for four states, offered the seminar to alleviate confusion about the consult code elimination. Many of the callers expressed concern over accurate use of modifier AI, which you should append to the attending physician's initial hospital care code. Remember that modifier AI is for inpatient use only, not for outpatient E/M codes. "The AI modifier is utilized only by the physician responsible for the overall care of the patient on [...]