99221-99223

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For the admitting physician, do you add the modifier AI to it? For other providers using this code for seeing the patient for this first time, do you ever get denials?
 

thomas7331

True Blue
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Most payers will allow one E&M visit per specialty per day for patients in the hospital, so as long as there are not multiple visits for physicians of the same specialty, it should not be a problem. You will use the AI modifier for the admitting physician's initial visit for payers that do not accept consultation codes so that they can distinguish the attending physician's initial service from the consulting physicians'.
 
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So I work for a urology office. So when our provider's go to the hospital to see the patients for a consult, I would use a code from 99221-99223 if the insurance does not accept a consult code. We rarely are the admitting provider. Am I correct in this?
 
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