# is this correct about "AI"?



## efuhrmann (Dec 21, 2009)

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???


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## Gemini18 (Dec 21, 2009)

efuhrmann said:


> 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.


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## cheermom68 (Dec 21, 2009)

*AI*

In the Open Door Forum by CMS, they reassured us that this would not happen.  The modifier is for informational purposes only.


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## efuhrmann (Dec 21, 2009)

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


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## cheermom68 (Dec 21, 2009)

*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.


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## Lisa Bledsoe (Dec 21, 2009)

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


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## kevbshields (Dec 21, 2009)

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 . . . "


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## FTessaBartels (Jan 7, 2010)

*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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