Wiki AI modifier

[JOHNSON]

My providers have raised alot of frustration in regards to their consults/admissions being downcoded to just a subsequent visit. They have explained to me that
when they are asked to consult on a patient they do all the required components to support a consult. They are stating that they don't want to continue to do a consult that is just going to be downcoded. Are there any forums available to help with this issue? Any other suggestions would be appreciated as well.

 

[csperoni]

1) Who is re-coding and why are they downcoding?
2) When CMS did away with consults (justifiably so due to abuse/overuse findings), their instructions were to bill an initial visit as 99221-99223. If it does not meet the requirements of 99221, you may then use subsequent 99231-99233.
3) Virtually all of my commercial contracts follow Medicare billing. They no longer accept consult codes, but they will accept 99221-99223.
4) Not sure what your question is regarding your title of AI modifier. AI is used on 99221-99223 by the admitting physician only.
If you do a search on the forums for hospital consult, you should find several other threads about this same question/issue.