UCR 278: E/M Leveling — It’s as Clear as Mud

February 27, 2026 

In this episode, Scott, Mark, and special guest Dr. John Lin tackle real-world evaluation and management (E/M) scenarios submitted by members of the Thriving Urology Practice Facebook Group.  Through practical examples—including BPH follow-ups, elevated PSA management, overactive bladder, recurrent UTIs, and constipation—they break down how to apply medical decision-making rules to determine the correct level of service. The discussion highlights chronic stable conditions, prescription drug management, documentation pitfalls, automatic downcoding, and the ongoing gray areas that make E/M leveling “clear as mud.” The key takeaway: understanding the rules is essential—but precise documentation is what ultimately gets you paid.