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is this correct about "AI"?

  1. Default is this correct about "AI"?
    Medical Coding Books
    I am hearing murmurring in the community that if the attending physician fails to use the AI modifier, the "consultants" will not be paid for 99221-99223???

  2. #2
    Default
    Quote Originally Posted by efuhrmann View Post
    I am hearing murmurring in the community that if the attending physician fails to use the AI modifier, the "consultants" will not be paid for 99221-99223???
    Hi Elizabeth -

    LOL.. I was just about to post that exact question.

  3. #3
    Location
    Evansville Indiana
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    451
    Default AI
    In the Open Door Forum by CMS, they reassured us that this would not happen. The modifier is for informational purposes only.

  4. Default
    I also participate in a forum by decision health and some participants on that forum say different...

  5. #5
    Location
    Evansville Indiana
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    451
    Default AI modifier
    This was directly from CMS, during the FAQ session. That question was asked and they said that the modifier was informational only and addition of or lack of placement of the modifier would not affect payment to the non-admitting physicians. Whether they follow their own directive or not remains to be seen but we can only go by what they say for now.

  6. #6
    Location
    Greeley, Colorado
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    2,045
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    I really wish they had come up with a modifier for the consultant to use, rather than the admitting doctor. Seems it would make more sense, but that's just me
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Location
    Louisville, KY
    Posts
    1,101
    Default
    I agree. It makes sense that we'd want to identify the consultants on the case, as the Attending is identified on institutional claims anyhow.

    You're not alone in being confused on this. My first response was, "this can't be right . . . "

  8. #8
    Location
    Milwaukee WI
    Posts
    4,466
    Default Oxymoron
    Isn't expecting something CMS does to "make sense" a kind of oxymoron?

    In my humble opinion, what would "make sense" would be to leave the codes alone and just PAY at the lower rate for initial or subsequent hospital visit, new or established patient. Then there wouldn't be any problems with crosswalks for those payers who are still recognizing the consultation codes (especially when you have other insurance involved).

    But then, no one asked me ...

    F Tessa Bartels, CPC, CEMC

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