First - Critical care IS an E/M code.
I can't see any reason to want to code both Critical Care and another E/M code (such as emergency service). If the patient is critically ill, and the care provided is critical care, then use ALL the time spent with the patient to determine the level of critical care (99291 and 99292 for as many units as documented).
You are correct, the only time you would use both critical care and another E/M code is when two distinctly separate visits occurred ... the patient did not require critical care on the first visit, but worsened and later the same day requried critical care.
Bear in mind that if you attempt to code both your documentation will have to clearly identify the separate encounters. Any time spent in performing any procedures or services separately reported from critical care CANNOT be counted in critical care time.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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