E&M Services Updates: A Guide to the Updated Medical Decision Making Table

Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working...
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Pre-recorded
60 Mins
Jill M. Young

Navigating the New Elements of Medical Decision Making: What's Changed and What Hasn't!

The "Elements of Medical Decision Making" table is a familiar document to professionals in coding, billing, and auditing. This table incorporates components from the Table of Medical Decision Making, which played a significant role in the 1995 and 1997 Guidelines for Evaluation and Management (E&M) services.

While some parts of the new table retain their familiarity, such as prescription drug management, drug therapy requiring intensive monitoring for toxicity, and decisions regarding major surgery, there are also novel elements in the Elements of Medical Decision Making. These new components encompass assessments necessitating an independent historian, considerations of social determinants of health, and the handling of parenteral controlled substances. Furthermore, some parts have taken on a fresh perspective or added nuances, like the review of prior external notes from various sources, decision-making regarding minor surgery with identified patient or procedure risk factors, and the independent interpretation of tests performed by other physicians or qualified healthcare professionals (not reported separately). 

This discussion has primarily revolved around elements from just two of the three columns found in the Elements of Medical Decision Making table. The primary objective of this webinar is to provide clarity on what remains consistent, what is newly introduced, and what has evolved into something different within this document.

The Elements of Medical Decision Making grid comprises three columns, each containing entries categorized as straightforward, low, moderate, and high. This session will guide you through a step-by-step examination of each component, offering an in-depth review of the entire document.

By the end of this webinar, our goal is to ensure your comfort and understanding of each element across all three columns.

Webinar Objectives


To effectively navigate the new Elements of Medical Decision Making, it is imperative for users to gain a comprehensive understanding of each section and its respective contents. This need for clarity became evident during the alterations made to the Office and Other Outpatient Service codes in 2021. Further refinements and elucidations were introduced with the modifications to Evaluation and Management Service codes in 2023.

In this webinar led by Jill M. Young, we will meticulously dissect each line within every section, facilitating a deeper comprehension of these components and their interconnectedness. This intimate knowledge is paramount, as it is the key to accurately determining the level of service, whether for code selection or auditing purposes.

Webinar Agenda


  • Introduction to the Elements of Medical Decision Making
  • The Evolution and Background of E&M Guidelines
  • Deconstructing the Elements: What's Old, What's New, and What's Different
  • A Step-by-Step Review of the Three Columns
  • Mastering the Art of Code Selection and Audit Readiness
  • Interactive Q&A: Your Key to Proficiency in Medical Decision Making

Webinar Highlights


  • If you have two acute complicated injuries, can you move from Moderate to High?
  • What is the difference is between an acute uncomplicated and an acute complicated illness?
  • What does it mean when an acute illness has systemic symptoms?
  • Who qualifies as an independent historian?
  • What is considered a “unique test”?
  • What qualifies as discussion of management on a patient?
  • What does the wording “with identified patient or procedure risk factors” mean
  • What does it mean to have a social determinants of health limit diagnosis or treatment?

Who Should Attend


Coders & Billers, Auditors, Office Managers, Office Administrators and Providers (physicians, NPs and PAs)

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