So, here we’ve provided a more simplified version of the grid and per the AMA guidelines, you have to fulfill two out of the three elements to build the associated code. If you create a decision making tree based on the three elements, you will throw out your lowest element satisfied and code the next lowest. Problems addressed and risk of complications for will likely be the deciding factors as they are the simplest to meet. With the recent changes of a level four, it’s simpler to meet and it's important to pay attention to avoid under coding.
Maritza, I'd like to second that. As we kind of alluded to earlier in the presentation there might now be times where in the past you might have coded a glaucoma patient as level three, which now due to instability or risk of progression that it's going to fall into a level four or moderate and data complexity is probably still not going to qualify for moderate, but your risk of complications are going to qualify for moderate based on the virtue of treatment and potential issues. So you’ve obtained a level four where in the past, I might have coded that as a level three in my practice.