In what situations is modifier AI used?

Modifier AI (principal physician of record) was developed when Medicare changed its consultation policy. It is intended to be reported on the initial day of service only by the physician who is reporting initial hospital care codes (99218–99220; 99221–99223; 99234–99236) or initial nursing facility care codes (99304–99306). It helps differentiate the attending physician from the consulting physician, who will report the appropriate hospital care code (99221–99223, 99231–99233) if the patient is an inpatient or 99201–99215 if the patient is in observation.

Is modifier AI used when an attending physician admits a normal newborn (99460) or when a physician admits to intensive care (99477) or critical care (99468, 99471, 99475)?

Because the consultation policy is a Medicare policy and the development of modifier AI is an outgrowth of that policy, its intended...

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