Wiki Crosswalking E&M Codes

[luvsgoofey]

Hello Fellow Coders

I need some assistance with cross walking CPT codes. It was suggested that these codes below are ok to crosswalk one for one. However, I am not an expert in E&M coding. It was my understanding that many of these codes are not meeting the components. I understand it is ok to down code but some of these cross walks would cost the client revenue. It would be my suggestion to select coding based on what is documented. I under stand that Medicare does not pay for consults and we need to have a cross walk. But what about Inpatient VS Observation. Any help would be grateful. Thank you.

99241-99201-99211
99242-99202-99212
99243-99203-99213
99244-99204-99214
99245-99205-99215
99251-99221-99231
99252-99222-99232
99253-99223-99232
99254/99255-99223-99233

99221-99218
99222-99219
99223-99220
99231-99234
99232-99235
99233-99236
99238/99239-99217

 

[mitchellde]

You cannot just crosswalk one visit level to another because they are not equal and the criteria is not the same. Some you must meet 3 out of the 3 key criteria and some you need to meet only 2 out of three. It really is based on the documentation and guidelines. Trying to make a standardized crosswalk is a lot of time spent trying to get that square peg into the round hole.
You do not need a crosswalk for consults, you just apply the criteria for which set you are going to use, new patient or established. A 99241 is no way equal to a 99211!

 

[luvsgoofey]

You cannot just crosswalk one visit level to another because they are not equal and the criteria is not the same. Some you must meet 3 out of the 3 key criteria and some you need to meet only 2 out of three. It really is based on the documentation and guidelines. Trying to make a standardized crosswalk is a lot of time spent trying to get that square peg into the round hole.
You do not need a crosswalk for consults, you just apply the criteria for which set you are going to use, new patient or established. A 99241 is no way equal to a 99211!

Thank you. I spoke my case and wanted to confirm I was not incorrect. Thank you for your assistance.