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    2023 Emergency Medicine Coding Guide

    Rates level of service required in emergency medicine.

    INSTRUCTIONS

    This guide reflects the 2023 AMA CPT Evaluation and Management (E/M) coding changes for Emergency Medicine. Definitions have been simplified and are based on the full coding guideline available here.

    When to Use
    • Use this tool to assist in determining the correct level of medical decision making (MDM) for your patient. 
    • Only 2 of the 3 sections need to be completed to determine the MDM, which correlates with level of service (LOS).
    Number and Complexity of Problems
    a. High: ≥1 chronic illnesses with severe exacerbation, progression, or side effects of treatment
    b. High: 1 acute or chronic illness or injury that poses a threat to life or bodily function
    c. Moderate: ≥1 chronic illnesses with exacerbation, progression, or side effects of treatment
    d. Moderate: 2 stable, chronic illnesses
    e. Moderate: 1 undiagnosed new problem with uncertain prognosis
    f. Moderate: 1 acute illness with systemic symptoms
    g. Moderate: 1 acute, complicated injury
    h. Low: ≥2 self-limited/ minor problems
    i. Low: 1 stable, chronic illness
    j. Low: ≥1 acute, uncomplicated illness or injury
    k. Low: 1 stable, acute illness
    l. Low: ≥1 acute, uncomplicated illness or injury requiring inpatient or obs care
    m. Minimal: 1 self limited/minor problem
    Risk of Morbidity, Mortality, or Complications
    High
    Moderate
    Low
    Minimal
    Amount and/or Complexity of Data
    ≥3
    2
    1
    0
    ≥3
    2
    1
    0
    ≥3
    2
    1
    0
    No
    Yes
    No
    Yes
    No
    Yes

    Result:

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