How is this procedure reported? A 20-year-old male was dropped off at the hospital emer- gency department with a knife hilt sticking out of his mid left anterior chest. The patient was not fully conscious. No one accompanied him. The patient was transported into the emergency department, and the attending emergency department physician began the evaluation. Physical examination was less than comprehensive. It was noted that whenever there was a peripheral pulse, the knife handle quivered. The attending emergency department physician initiated trauma team mobilization and ordered necessary diagnostics and fluid/ blood replacement products. A partial history was obtained and documented by the attending emergency department physician. Care of the patient proceeded under the attending emergency department physician’s management. Twenty minutes after the patient was brought into the emergency department, the on-call trauma surgeon arrived in the emergency department, and the attending emergency department physician transferred care of the patient to the surgeon. The patient’s need for a high-level E/M service and inability to provide a comprehensive history, as well as the unsuitability of an initial comprehensive examination, was evident in the medical record.