Wiki New E/M vs Est E/M Crosswalk

[czavala]

Does anyone know if there is a published crosswalk between New E/M's vs. Established E/M's? For example, I'm looking for a published document from CMS or the OIG that states a 99203 would crosswalk to a 99214.

Thank you

 

[thomas7331]

There is no way to accurately crosswalk a new patient code to an established patient code. Since the criteria for new requires 3 of 3 elements and for established only 2 of 3, and since either code may be based on time, I don't know of any way that a new patient service could be reliably recoded to established without a review of the documentation. Some payers do crosswalk from new to established when the claims systems identifies that the patient is not new to the provider, but that is a reimbursement policy decision that is done for payment purposes and is not based on correct coding guidelines, so a crosswalk such as that, if it exists, would not be something that would be useful to a coder for E&M level choices.