Evaluate E/M Level

post

https://api.embercopilot.ai/v1/coding/em

Analyzes clinical documentation to determine the appropriate Evaluation & Management (E/M)
CPT code by assessing the three components of Medical Decision Making (MDM):

Number and complexity of problems addressed — from minimal to high complexity
Amount and complexity of data reviewed — labs, imaging, external records, etc.
Risk of complications and/or morbidity or mortality — from minimal to high risk

The highest two of three MDM components determine the overall MDM level, which maps to
the E/M CPT code for the given place of service and patient type.

The response includes the selected E/M code, the MDM level, and a detailed reasoning
trace explaining how the level was derived from the documentation.

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Body Params

inputText

string

required

Clinical documentation text to analyze for E/M level determination.

placeOfService

string

enum

Defaults to Office

Clinical setting where the visit occurred. Determines which E/M CPT code family applies.

Office (CMS POS 11) — 99201-99215
Inpatient Hospital (CMS POS 21) — 99221-99223 (initial), 99231-99233 (subsequent)
Outpatient Hospital (CMS POS 22) — hospital outpatient E/M
Emergency Room (CMS POS 23) — 99281-99285
Nursing Facility (CMS POS 31/32) — 99304-99310

Allowed:

patientType

string

enum

Whether the patient is new or established to the rendering provider.
A new patient has not received professional services from the provider (or another
provider of the same specialty in the same group) within the past three years.

Allowed:

visitType

string

enum

Applicable for inpatient and nursing facility encounters.

Initial — first encounter during the admission
Subsequent — follow-up encounters during the same admission

Allowed:

duration

integer

≥ 0

Total time spent on the encounter in minutes, including face-to-face and non-face-to-face time on the date of the encounter.

specialty

string

enum

Provider specialty. When provided, E/M evaluation is tailored to specialty-specific documentation patterns and coding guidelines.

Responses

200Successfully evaluated E/M level

400Bad request due to invalid input

401Unauthorized - Invalid or missing API key

429Too Many Requests - Concurrent request limit exceeded

500Internal Server Error