If you are the consulting, you may bill 99251-99255 if the carrier accept consultation codes, and you meet the other requirements for consult. If the carrier does not, I agree it is confusing as I have also found conflicting advice.
Per Supercoder under 99251-99255:
When an inpatient consultation is performed on a date that a patient is admitted to a hospital or nursing facility, all evaluation and management services provided by the consultant related to the admission are reported with the inpatient consultation service code (
99251-
99255). If a patient is admitted after an outpatient consultation (office, emergency department, etc), and the patient is not seen on the unit on the date of admission, only report the outpatient consultation code (
99241-
99245).
If the patient is seen by the consultant on the unit on the date of admission, report all evaluation and management services provided by the consultant related to the admission with either the inpatient consultation code (99251-99255) or with the initial inpatient admission service code (99221-99223).
Per Supercoder under 99221-99223:
For initial inpatient encounters by physicians other than the admitting physician, see initial inpatient consultation codes (99251-99255) or subsequent hospital care codes (99231-99233) as appropriate.
In our practice, if not admitting & insurance accepts consult, we bill 99251-99255 for initial visit.
If not admitting & insurance does not accept consult, we bill 99221-99223 IF SAME DAY AS ADMISSION (no modifier), or 99231-99233 if different day than admission.
If admitting, 99221-99223 for initial visit with -AI.
Hope that helps.