Is there a code “crosswalk” from outpatient consultation codes to E/M codes?
A. The selection of an E/M code is based on the E/M guidelines that define the history, exam and decision making. Alternately, eye codes apply when the documentation supports their use. • 99241 = 99201 or 92002 • 99242 = 99202 or 92002 • 99243 = 99203 or 92004 • 99244 = 99204 • 99245 = 99205 Because the E/M definitions are more lenient for established patients, the crosswalk is more complex. Possible eye code choices are provided for consideration: • 99241 = 99212 or 92012 • 99242 = 99213 or 92012 • 99243 = 99214 or 92014 • 99244 = 99215 • 99245 = 99215 Q. Is there a code “crosswalk” from the inpatient consultation codes to the E/M codes? A. It’s challenging, because there are only three CPT codes for initial facility care whereas there were five levels of inpatient consultation codes. The history and exam for 99251 and 99252 are too abbreviated to crosswalk to an E/M code. Possible choices are: • 99251 = 92002 / 92012 • 99252 = 92002 / 92012 • 99253 = 99221, 99304, 92004 or 92014 • 99
