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Public release of Cigal Concepts' internal tool for reviewing and refining facility-level E/M charge accuracy in emergency departments.

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🏥 Cigal Concepts – Facility Acuity Matrix Tool (Public Use)

Tool for evaluating and improving facility-level emergency department charge accuracy. Released publicly by Cigal Concepts. Version Date: October 13, 2023
Author: Tracy Bostrom
Company: Cigal Concepts, Inc.
License: CC BY-NC 4.0
Use Case: Internal audit, clinical education, facility charge analysis
Status: Public Release (non-commercial)


📘 Purpose

This tool helps audit and analyze facility-level E/M charges for Emergency Department visits. It is not a billing tool — it supports clinical documentation review and can guide refinement of local charge assignment processes.


🔄 Recommended Use Process

🔍 Start from the bottom up.

When performing a retrospective review or internal audit:

  1. Begin with:

    • Discharge Instructions
    • Disposition
    • Medications Given
  2. Then:
    Starting from Level 5, work to the right.
    Scan each level’s Assessment and Diagnosis/Treatment section until the highest level of documented service is found.

  3. Assign the visit the highest level where any qualifying item is documented.

💡 Only one item is required to qualify for a level — but reviewers must ensure accurate documentation supports the selected level.


📊 Matrix Overview

Each visit is evaluated using the following categories:

  • Assessment
  • Diagnosis / Treatment
  • Medication
  • Disposition
  • Discharge Instructions

LEVEL 5 – High Complexity

(See full matrix content in the repository documentation)

LEVEL 4 – Moderate Complexity

(See full matrix content in the repository documentation)

LEVEL 3 – Average Complexity

(See full matrix content in the repository documentation)

LEVEL 2 – Low Complexity

(See full matrix content in the repository documentation)

LEVEL 1 – Minimal Complexity

(See full matrix content in the repository documentation)


🛡 Legal & Ethical Notice

This tool is publicly shared by the author as an educational and quality improvement framework. It is not intended to replace coder/auditor judgment or regulatory coding guidelines.

  • No CPT descriptions are included
  • No patient data is shared
  • No revenue is collected from this release

© 2023 Tracy Bostrom / Cigal Concepts
Licensed under CC BY-NC 4.0

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Public release of Cigal Concepts' internal tool for reviewing and refining facility-level E/M charge accuracy in emergency departments.

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