CAC E/M Tool - 1st Draft Demo

COPA

Please fill out the below information to determine the E/M level

# of Acute Chronic Illness or Injury with Threat to Life

# of Acute Complicated Injury

# of Acute Illness With Systemic Symptoms

# of Acute Uncomplicated Illnesses

# of Chronic Illnesses with Exacerbation

# of Chronic Illnesses with Severe Exacerbation

# of Self-Limited / Minor Problems

# of Stable Acute Illnesses

# of Stable Chronic Illnesses

# of Undiagnosed Problems