tci Medicare Compliance & Reimbursement - 2010 Issue 4

PART B CONSULTATION ELIMINATION: Forget to Append Modifier AI to Inpatient Hospital Visit Claim? This MAC Will Still Reimburse You

Plus: You no longer need to list the ordering/referring physician as item 17 on your claim form when a 'consult' takes place, since CMS doesn't recognize consults. If you forget to append modifier AI (Principal physician of record) to your initial hospital care claims, you'll still collect your fees, at least from one Medicare payer. That was the word from the Feb. 9, 2010 NGS Medicare Part B Consultation Coding Changes conference call. NGS, which is the Part B MAC for four states, offered the seminar to alleviate confusion about the consult code elimination. Many of the callers expressed...

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