Question on ED Facility Level Guidelines - Need Clarifiication - LEVEL 4 or 5

Working for multiple facilities, every one has their own guide on the facility leveling. A question brought up on whether to charge a level 4 or 5. According to the Level 4 intervention guidelines, preparation for 2 diagnostic tests which would include EKG, LABS or XRAY. Special Imaging such as CT, MRI, Ultrasound, or VQ Scan. Level 5 states preparation for >3 diagnostic tests and special imaging including contrast or parental medication.

Some coders view this as if a patient came in had lab work, EKG and Chest X-Ray, full physical exam and ROS, no HX, no meds given or prescribed, would give this patient a level 5 because of the 3 tests whereas others say it should only be a 4.

Is high tech radiology - MRI, CT, VQ, U/S not required to even get a level 4 to begin with?

Any help you can offer would be appreciated even just general E&M guidance and examples. Thank you!

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Question on ED Facility Level Guidelines - Need Clarifiication - LEVEL 4 or 5