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)
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.
🔍 Start from the bottom up.
When performing a retrospective review or internal audit:
-
Begin with:
- Discharge Instructions
- Disposition
- Medications Given
-
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. -
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.
Each visit is evaluated using the following categories:
- Assessment
- Diagnosis / Treatment
- Medication
- Disposition
- Discharge Instructions
(See full matrix content in the repository documentation)
(See full matrix content in the repository documentation)
(See full matrix content in the repository documentation)
(See full matrix content in the repository documentation)
(See full matrix content in the repository documentation)
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