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Wiki consultation coding with Medicare

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suzannereed

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Do I need the mod AI on a 99291 in the case that another physician is called in? In other words, my doc is the admitting physician, but the patient went from ER to ICU. I'm trying to code for a Critical Care and Infectious Disease doctor.:confused:
 
I do not believe so

I do not believe so. The AI modifier was specifically developed when Medicare decided they would pay for more than one "initial hospital visit" when submitted by different physicians during one hospital stay.

The Critical Care codes were ALWAYS payable to different physicians (different specialties and/or different practices) during the same hospitalization - even on the same DOS.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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