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
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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