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I, personally, think the hardest part about this is that we are not coding for an actual physician.  Therefore, we can't take the coding question straight to him or her and ask about the documentation or physical exam or decision making.  We can only use the information that we are given.  It is similar when coding diagnoses...currently I work in data entry for Meaningful Use.  After the switch to ICD-10, one of my doctors still used ICD-9 codes.  That should not be a problem because I work on a website that will convert them.  (And I learned a ton and did well in Module I.  Thank you Andrews School!)  However, there are ICD-9 codes that do not convert because of the specificity improvement in ICD-10.  I work from home and do not have access to the physician.  So, there are times that I have to select the least specific code that matches.  If I wasn't in coding school, I would have no clue what to do.  So when I look at questions in Module II, I now remind myself that if this were an actual work situation, and there was ambiguity about the documentation, I would query the physician.  Since I cannot do that, I either ask Peggy for clarification if I'm really stumped or I remember that I can only code with what information I have in front of me.  As for the E/M section, I just started it.  I have decided to take this section very slow and re-read each section.  As I go, I am making a chart that contains ALL of the diagrams from the Keuhn book and puts them into one document that can sit in front of me as I work on the practice problems.  I don't want to have to flip back and forth between the key components when I start the exam.