Thank you Tonyj, I understand what you're saying here and don't disagree with the risks associated with this drug. However, there are many other commonly prescribed drugs that carry the same black box warning (e.g. Cipro, Zoloft, Synthroid), but that does not warrant automatic assignment of high risk to an E&M level. The important point is that E&M guidelines always direct you to the provider's documentation, not to any outside source or list. Again, the table of risk is a guideline and a tool for assessing the level of risk as documented in the patient's record.
I don't say this just as a matter of personal opinion, but based on my experience with many first- and second-level appeals of CMS and commercial payer downgrades of E&M code levels where high-risk drugs are part of the treatment plan. The auditors in these organizations are very firm in holding that the appearance of a particular drug's name in a note by itself is not sufficient to warrant high risk if it is not accompanied by provider documentation that also reflects their assessment of the associated level of risk to the particular patient and/or encounter.
Of course, payers and their rules and practices vary greatly, so different coders and auditors may have had different experiences. Ultimately, no one can give you an yes or no answer on something like this. We all need to consider our providers' documentation and follow our own judgment on what is best, and be prepared to defend our decisions. After all, if there was always a 'right' answer, then computers could be programmed to code charts and there wouldn't be a need for a coders at all.