Gastroenterology Coding Alert

Question: A patient with abdominal pain presents to the ED, where the on-call gastroenterologist sees her. The patient undergoes an abdominal scan and laboratory tests, but when the patient begins vomiting blood, the gastroenterologist is called back to resume the care in the intensive care unit. The same on-call gastroenterologist then provides critical care for 35 minutes in total in the intensive care unit. How should I report this?

Texas Subscriber

Answer: In this case, you should report 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) only. You must consider the emergency department (ED) visit as a component of the comprehensive critical care service. You cannot report the service separately by using a modifier either.