> ## Documentation Index > Fetch the complete documentation index at: https://developer.suki.ai/llms.txt > Use this file to discover all available pages before exploring further. # E/M Coding Overview > Learn how Suki generates E/M code recommendations, supports revenue cycle workflows, and integrates with Ambient or standalone APIs > [!NOTE] > > **E/M Coding is supported by:** E/M Coding APIs and Ambient APIs Suki's [E/M Coding](https://www.aapc.com/resources/what-are-e-m-codes) capability recommends Evaluation and Management (E/M) codes (Visit codes that describe the level of evaluation and management provided during an encounter. These codes are used for billing. Examples include office and outpatient codes such as 99214.) based on the clinical documentation for a visit. E/M codes are used to describe the level of care provided during an encounter and help determine how that visit is billed for payment. When you use E/M Coding capability, it enables you to recommend E/M codes after the note is ready, so clinicians or coding teams can review and accept a starting point instead of coding from scratch. You can request recommended E/M codes from Suki in two ways: * **With an existing Ambient workflow:** If your application already uses Suki Ambient APIs to capture patient-provider conversations and generate clinical notes, enable E/M Coding when creating the ambient session by setting `artifacts: ["EM_CODES"]`. Include the patient, provider, and visit details as usual. * **With a completed clinical note that you already have:** If your application or EHR already has a completed clinical note, send its sections to Suki using the standalone E/M Coding APIs. Suki analyzes the note and returns the recommended E/M codes without requiring an Ambient session. Suki analyzes the clinical note along with available visit details, such as patient information, diagnoses, and encounter context. It returns recommended E/M codes with supporting information that explains why each code was selected, when that information is available. Your application can display these recommendations for clinician or coding review. Once a reviewer accepts a recommendation, your application can pass the selected code into your existing billing workflow. > [!NOTE] > > * Suki only provides coding recommendations. Your application remains responsible for the review, code selection, and subsequent billing process. > * Supporting rationale or evidence is included only when applicable for the coding path Suki used. For example, MDM-based codes can include `rationale`, and time-based or wellness codes can include `evidence`. > * E/M Coding is in **Beta**. Behavior and response fields can change based on user feedback. > * E/M Coding must be enabled for your organization. Contact [support](mailto:support@suki.ai) or the [Partnership team](https://www.suki.ai/contact-us/) to enable the capability. These definitions describe the terminology used on this page. | Term | Meaning | | :- | :- | | E/M Coding | Generates recommended visit codes from a completed clinical note. Suki does not submit codes to payers or update your EHR. | | Revenue cycle management (RCM) | The processes involved in reviewing clinical documentation, assigning codes, capturing charges, and submitting claims for payment. | | With Ambient Session | Generates E/M code recommendations using the note from an existing ambient session. | | With Standalone Note | Generates E/M code recommendations by submitting an existing clinical note through the E/M Coding APIs, without an ambient session. | ## How E/M Coding supports revenue cycle management Clinical documentation is only one part of the post-visit workflow. Once a note is complete, clinicians or coding teams must determine the appropriate visit code before the encounter can move through billing. E/M Coding helps with this step by analyzing the completed note and available encounter details to recommend an appropriate Evaluation and Management code. It also provides supporting rationale to help reviewers understand the recommendation. With Suki's E/M Coding capability, you can: > [card] Move from Documentation to Coding > > Extend your existing Ambient or Dictation workflows beyond note creation. Generate E/M code recommendations once the clinical documentation is ready. > [card] Give Reviewers a Starting Point > > Present recommended codes with supporting rationale so clinicians and coding teams can review the results instead of starting the coding process from scratch. > [card] Keep Your Existing Billing Workflows > > Integrate code recommendations into your EHR or RCM application. Your application controls code review, acceptance, and submission. > [card] Support Different Integration Needs > > Generate codes as part of an existing ambient session or use the standalone APIs to process notes already available in your application. > [!NOTE] > > * E/M Coding recommends office and outpatient E/M codes from a completed clinical note. If you bill by time, include the total minutes (`total_time_minutes`) as a number greater than 0. > * For a preventive or wellness visit, include the patient's date of birth, the date of the visit, and a visit type Suki supports. This helps Suki apply the right criteria for the recommended code. ## Common use cases > [card] E/M Coding for Ambient Visits > > Your application already uses Ambient APIs to document patient visits. Enable E/M Coding on that session with `artifacts: ["EM_CODES"]`, then read the recommended E/M code and the reason after the note is ready. You do not call a separate generate E/M codes API. > [card] E/M Coding for Existing Clinical Notes > > Your EHR already creates clinical notes, and you are not using Suki Ambient APIs for this visit. Submit the completed note with Suki's standalone E/M Coding APIs, then read the codes with the coding `session_id` Suki returns. This does not change how you create or store the note. > [card] Time-Based Visit Coding > > Your clinicians bill based on the time spent with patients. Include the total visit time as `total_time_minutes` on the Ambient session or the standalone encounter, using a number greater than 0. > [card] Preventive and Wellness Visit Coding > > Your application handles preventive care and wellness visits. Include the visit type, the patient's date of birth, and the date of service when you ask Suki to recommend an E/M code. The visit type must be one Suki supports. > [!TIP] > > If the visit has not yet been documented, use [Ambient](https://developer.suki.ai/documentation/concepts/ambient-clinical-notes/ambient-documentation.md) or your existing documentation workflow first. > [!NOTE] > > E/M Coding works with clinical notes; it does not independently record or transcribe patient conversations. ## How E/M Coding works The integration follows the same general process whether you use Ambient or the standalone APIs: ![E/M Coding workflow: Start with a completed visit note, choose the Ambient or standalone integration path, receive recommended visit codes from Suki, and review and submit the accepted code.](https://mintcdn.com/suki-1e08f176/pF0w94HUbC96pJHg/documentation/assets/diagrams/concepts-em-coding-overview-4-light.svg?fit=max\&auto=format\&n=pF0w94HUbC96pJHg\&q=85\&s=183ba763583fb965526b62643c0a849c) ```mermaid actions={false} theme={"theme":{"light":"one-light","dark":"material-theme-darker"}} flowchart LR A[Completed visit note] --> B{Using Ambient?} B -->|Yes| C[Generate codes with the Ambient session] B -->|No| D[Submit the note through standalone APIs] C --> E[Suki generates E/M code recommendations] D --> E E --> F[Review and submit the accepted code] style A fill:#FFF394,stroke:#333,color:#000 style B fill:#FFF394,stroke:#333,color:#000 style C fill:#FFF394,stroke:#333,color:#000 style D fill:#FFF394,stroke:#333,color:#000 style E fill:#FFF394,stroke:#333,color:#000 style F fill:#FFF394,stroke:#333,color:#000 ``` Choose the integration path that matches your existing workflow. Refer to [Choose Ambient or standalone](https://developer.suki.ai/documentation/concepts/em-coding/choose-ambient-or-standalone.md) for a detailed comparison of both approaches. ## Information you need to provide to Suki for E/M Coding E/M Coding uses the completed clinical note and available encounter details to generate code recommendations. Providing relevant patient, provider, and visit information helps Suki evaluate the appropriate coding criteria. | Information | What to provide and why | | :- | :- | | **Clinical note** | Provide the clinical note that Suki should use for E/M coding. Each note section must include a LOINC code (`loinc`) and its text in `content.text`. For Ambient sessions, Suki generates the note sections. For standalone coding, your application must send them. At least one section must contain text. | | **Patient type** | Specify whether the patient is new or established. Suki uses this information to determine which E/M codes apply to the visit. | | **Date of birth, date of service, and visit type** | Provide these details for preventive and wellness visits. The visit type must match one of the [Visit types supported by Suki](https://developer.suki.ai/api-reference/info/visit-types.md). | | **Total visit time** | If the visit is billed based on time, provide the total time in minutes using `total_time_minutes`. Pass this value with the Ambient session or standalone encounter. The value must be a number greater than `0`. | | **Existing diagnoses** | Optionally provide diagnoses already recorded for the patient. Suki uses supported diagnosis information as additional context when recommending E/M codes. See [Provide existing diagnoses](#provide-existing-diagnoses). | | **Clinician NPI and insurance** | Provide the clinician's NPI and insurance information to give Suki additional context for the coding recommendation. | ### Provide existing diagnoses Diagnoses and E/M codes describe different aspects of a visit. A diagnosis identifies a patient's medical condition, such as hypertension. An E/M code, such as `99214`, represents the level of service provided during the visit. If you already have diagnoses for the encounter, include them in `diagnoses.values`, with a code and short description for each diagnosis. Suki uses ICD-10 and IMO diagnoses alongside the clinical note when recommending an E/M code. Your existing diagnoses remain unchanged. ### Supported diagnosis types An E/M Coding request treats these diagnosis types as follows: * **ICD-10:** Used when evaluating the encounter and recommending an E/M code. * **IMO:** Used when evaluating the encounter and recommending an E/M code. * **SNOMED:** Accepted in the diagnosis list but not used to determine the E/M code. * **HCC:** Not accepted as a diagnosis type in E/M Coding. Sending an HCC diagnosis causes validation to fail. HCC categories returned in [Ambient structured data](https://developer.suki.ai/api-reference/ambient-content/structured-data.md) are separate from E/M Coding recommendations. Send the diagnosis types your application already stores. You do not need to convert them to another supported format. ## Review the E/M Coding recommendations Suki returns a recommended E/M code with the reasoning behind it. A clinician or coding team can review the recommendation, verify the supporting details, and accept or change the code before billing. Suki does not approve codes on your behalf, submit claims, or replace your existing billing workflow. Your application remains responsible for sending the approved code to your billing system. > [!NOTE] > > * **Field names and payload examples** are in the how-to for your path. > * Use [Add E/M codes to an ambient visit](https://developer.suki.ai/documentation/how-to/em-coding/generate-with-ambient.md) when coding runs with an ambient session, or [Generate E/M codes from a note](https://developer.suki.ai/documentation/how-to/em-coding/generate-standalone.md) when you submit a note through the standalone APIs. > * After coding finishes, [Get the generated E/M codes](https://developer.suki.ai/documentation/how-to/em-coding/retrieve-em-codes.md) covers how to read the response. ## Related guides > [card] [What E/M Coding Is](https://developer.suki.ai/documentation/concepts/em-coding/what-is-em-coding.md) > > Understand E/M visit codes, how they are selected, and what Suki returns. > [card] [Choose Ambient or Standalone](https://developer.suki.ai/documentation/concepts/em-coding/choose-ambient-or-standalone.md) > > Compare both integration approaches and choose the one that fits your application. > [card] [Add E/M Codes to an Ambient Visit](https://developer.suki.ai/documentation/how-to/em-coding/generate-with-ambient.md) > > Enable E/M Coding for an ambient session, provide visit details, and retrieve the recommendations. > [card] [Generate E/M Codes from a Note](https://developer.suki.ai/documentation/how-to/em-coding/generate-standalone.md) > > Submit a completed note through the standalone APIs and retrieve the recommended codes. > [card] [E/M Coding APIs Overview](https://developer.suki.ai/em-coding-api-reference/overview.md) > > Explore the standalone endpoints, authentication, and asynchronous generation workflow. > [card] [Get the Generated E/M Codes](https://developer.suki.ai/documentation/how-to/em-coding/retrieve-em-codes.md) > > Learn how to retrieve and interpret the generated codes and their supporting rationale. 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