Encounter checker
Bring the right questions to each encounter.
Check a hypothetical encounter against reviewed payer guidance. Missing conditions stay unresolved; a match is never a guarantee of payment.
What you’ll see
The evidence, with its limits.
- 01 · Payer and product scope
- 02 · Conditions met, not met, or still unknown
- 03 · Source links and the evidence date
- 04 · Open questions for your coding team
You can look up source evidence. Claim-level recommendations become available after the billing rules complete clinical review.
What supports the E/M level?
Review medical decision making or time under the applicable E/M rules. Visit number and a pregnancy diagnosis do not determine the level. For example, a routine follow-up and a visit involving an actively managed complication may need different documentation.