Mod AI on 99291?

AmandaW

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If it IS the initial visit in the hospital and happens to be critical care-99291 instead of the normal 99221-99223, would you still put the Modifier AI on it if the doc was the admitting or does it only go on the 99221-99223?

Also, initial observation....99218-99220....AI on those?


Thanks!
 

kvangoor

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AI is for inpatient codes so they would not be needed on initial obs 99218-99220. If the critical care code is the initial visit and they are the admitting doc then I believe it would be correct. Here is what I found on the Medicare website.

Appropriate Usage
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
 

kjstearns

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No, it's not necessary to add the AI to critical care codes if they are being used instead of admit codes. Since Medicare did away with consultation codes and advised all providers to instead use the initial inpatient/admit codes (99221-99223), the AI is used to differentiate the actual admitting physician from all the rest.

Hope this helps!

~Kirsten, CPC
 
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