E/M Code Calculator

Number and Complexity of Problems Addressed (info)

Tell us about the problems being addressed during the visit. Use the counter to quantify the number of problems being addressed in each category.

Self-limited or minor problem(s) (info)

Stable chronic illnesses (info)

Acute, uncomplicated illness or injury (info)

Chronic illnesses with exacerbation, progression, or side effects of treatment (info)

Undiagnosed new problem with uncertain prognosis (info)

Acute illness with systemic symptoms (info)

Acute complicated injury (info)

Acute or chronic illness or injury posing a threat to life (info)

Amount and/or Complexity of Data (info)

Tell us about the data reviewed for the visit. Use the counter to quantify the amount of data elements reviewed or tests ordered in each category. If you communicated with another physician about the patient or personally reviewed an image, tracing or specimen, be sure to click the relevant boxes to get proper credit for these services.

Category 1: Tests, documents, or independent historian(s)

Review of prior external note(s) from each unique source (info)

Review of the result(s) of each unique test (info)

Ordering of each unique test (info)

Assessment requiring an independent historian(s) (info)

Category 2: Independent interpretation of tests

Independent interpretation of an image, tracing or specimen that you are not billing for separately (e.g., EKG, CXR, etc.) (info)

Category 3: Discussion of management or test interpretation

Discussion of management or test interpretation with external physician/other qualified health care professional/appropriate source (info)

Risk of Complications (info)

Tell us about the risk. Click all elements which apply to this visit. It’s okay to click multiple boxes; the calculator will figure it out.

Minimal risk: This means there is no chance that the patient’s overall health status will be adversely affected by the issues being addressed and complete resolution of the problem is expected with or without treatment. (info) Low risk: There is little to no chance the overall health status of the patient will be adversely affected by the issues being addressed as long as the problem(s) are stable and are being appropriately treated and monitored. (info)

Moderate Risk Criteria: Prescription drug management (info) Decision regarding minor surgery with identified patient or procedure risk factors (info) Decision regarding elective major surgery without identified patient or procedure risk factors (info) Diagnosis or treatment significantly limited by social determinants of health (info) None of the above, but I consider the encounter to be of moderate risk based on my clinical experience and judgment (info)

High Risk Criteria: Drug therapy requiring intensive monitoring for toxicity (info) Decision regarding elective major surgery with identified patient or procedure risk factors (info) Decision regarding emergency major surgery (info) Decision regarding hospitalization or escalation of level of hospital care (info) Decision for DNR or for de-escalation of care (info) Parenteral controlled substances (info) None of the above, but I consider the encounter to be of high risk based on my clinical experience and judgment (info)