Office Visit E/M Coding Calculator

A Resource Designed to Assist Providers with Appropriate Code Selection

The E/M Coding Calculator is a resource designed to assist providers with appropriate code selection for evaluation and management services. This tool is a simplified version of the Novitas auditor’s instructions, and can be used as a guide to understand the evaluation and management coding and documentation guidelines.

Page One includes a snapshot of the levels of service used in the outpatient care setting and their documentation requirements. Page One also includes time thresholds for each level of E/M service, and the specific documentation requirements for time-based billing.

Page Two includes the formula for calculating history, exam, and medical-decision-making along with a table outlining the differences between body areas and organ systems, which is particularly important when calculating physical exam.