After the inpatient consolation codes (99251-99255) became obsolete with Medicare, these codes (Initial and subsequent) were to be utilized when billing Medicare.
My understanding is the Attending would utilize the 99221 on the same day of admission (with a pertinent modifier to indicate they are attending) and then consultations for this patient by other physicians would utilize 99231 for subsequent hospital care. My intuition tells me the pain doc isn't the attending in this case. The modifier 55 seem odd. More information would help to be sure the pain do wasn't doing daily hospital management for and epidural catheter (01996). In the case we were paid for in 2k10, 99231 paid the E/M visit for a medicare inpatient seen by our pain doc.
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