The steps that are needed to figure out the E/M level are as follows, 1.Identify the category and subcategory of service, 2.Review the reporting instructions for the selected category or subcategory, 3.Review the level of E/M service descriptors and examples in the selected category or subcategory, 4.Determine the extent of history obtained, 5.Determine the extent of examination performed, 6.Determine the complexity of medical decision making, 7.Select the appropriate level of E/M services. The American Medical Association's Current Procedural Terminology (CPT) manual and the Centers for Medical & Medicaid Services (CMS) guidelines is what I use to reference information about the steps needed to figure what level E/M to use. It is important to get the right E/M so that your patient doesn't get billed any procedures that were not performed on the. If you charge them with something like that you could get sued and your workplace would lose credit. You can lose your job if the payout from the customer is bad.I feel it is better for Miranda to take a direct approach and the reason is Nicole is a new hire and has been late 4 times in 3 weeks and Miranda needs Nicole to be on time