What is modifier A1 used for?

A. Because modifier “-AI” (not modifier “-A1”) is the appropriate modifier to identify an initial hospital or nursing home E/M service by the patient’s principal physician of record, payment to the provider for the E/M service could be affected.

When should modifier AI be used?

Modifier AI is used identify the principal physician of record during an inpatient admission. This modifier should only be used by the admitting or attending physician overseeing the patient’s care during a hospital or nursing facility admission.

What is A1 modifier for Medicare?

Modifier “-AI,” defined as “Principal Physician of Record,” shall be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who may be furnishing specialty care. The principal physician of record shall append modifier “-AI” in addition to the initial visit code.

Is AI modifier for Medicare only?

Medicare can allow services provided by a physician called in to see the patient even though the principal physician of record does not append this modifier to his/her claim or he/she has not yet submitted the claim to Medicare. This is an informational only modifier.

What modifier is used for hospice patient?

Modifier GV
Hospice Modifier GV This modifier should be used by the attending physician when the services are related to the patient’s terminal condition or not paid under arrangement by the patient’s hospice provider.

What is the difference between modifier as and 80?

ANSWER: As you stated, modifier -80 identifies a healthcare professional who supports the efforts of the surgeon during a procedure. Note that “by another physician” is NOT part of this modifier description. Modifier -AS specifies the qualifications of this assistant.

What is the AF modifier?

specialty physician
This modifier is used to indicate a specialty physician.

What is the GA modifier used for?

The GA modifier must be used when physicians, practitioners, or suppliers want to indicate that they expect that Medicare will deny a service as not reasonable and necessary and they do have on file an ABN signed by the beneficiary.

What is a GZ modifier for Medicare?

The GZ modifier indicates that an ABN was not issued to the beneficiary and signifies that the provider expects denial due to a lack of medical necessity based on an informed knowledge of Medicare policy.

What is the A1 modifier for physician of record?

USE OF A1 MODIFIER. “Modifier “-AI,” defined as “Principal Physician of Record,” shall be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who may be furnishing specialty care. The principal physician of record shall append modifier “-AI” in addition to the initial visit code.

Can I use the -AI modifier with a subsequent visit code?

No, don’t use the -AI modifier with a subsequent visit or discharge code. Use it only with an initial hospital care code (99221-99223) for the first visit if you’re the principal physician of record.

What does the modifier -AI mean on form 99223?

Here’s Medicare’s explanation: Here’s what CMS says with regard to 99223: “Modifier “-AI,” defined as “Principal Physician of Record,” shall be used by the admitting or attending physician who oversees the patient’s care, as distinct from other physicians who may be furnishing specialty care.

Which modifier is appropriate to identify an initial hospital E/M service?

Because modifier “-AI” (not modifier “-A1”) is the appropriate modifier to identify an initial hospital or nursing home E/M service by the patient’s principal physician of record, payment to the provider for the E/M service could be affected.