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Physician standby

Kristen Posted Mon 16th of May, 2011 19:43:03 PM

Is 99360 a billable code? Does Medicare,Anthm etc recognize this code?

SuperCoder Answered Tue 17th of May, 2011 02:12:11 AM

No. Medicare does not pay for this code; however it maintains values to help other payers that accept this code.

Nikhil Answered Tue 17th of May, 2011 02:55:09 AM

Medicare doesn't pay and many payors may not pay. But, experts reccommend that 99360 is Payable[payors other than Medicare]subject to the following conditions:-
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Be sure the physician has documented the standby service with something such as: I was requested by [DOCTOR’S NAME] to be on standby for the pacemaker implant performed on [PATIENT’S NAME] on [DATE]. I arrived at the operating room at [ARRIVAL TIME] and departed at [DEPARTURE TIME].
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Note: When standby care is requested, both the requesting physician and providing physician must document the need for standby care regardless of whether a claim for reimbursement is submitted.
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If you submit a claim, be sure to follow the CPT guidelines for 99360, which include:-
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Another physician must document in writing the request for the standby service.
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The standby physician must not provide care to other patients during the standby period.
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The standby physician should not submit 99360 for any service of less than 30 minutes total on that date of service. You may report an additional unit of 99360 for each additional 30 minutes, meaning another full 30 minutes of standby service.
If the physician is called upon during the procedure to place epicardial leads, you should report the code for the service provided rather than reporting 99360.

SuperCoder Answered Tue 17th of May, 2011 03:18:31 AM

Exactly right, agree with Patrick. Just see an updated example of this quarter.
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Question: My doctors stand by for the cardiologists during a pacemaker placement in case they need to place epicardial leads. They want to report their time, and I have found 99360 for this. Do they need to dictate something in order for me to charge for this?
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Answer: CMS and many other payers do not pay for 99360 (Physician standby service, requiring prolonged physician attendance [face-to face] without direct patient contact, each 30 minutes [example., operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring EEG]), so that the doctor may not be able to charge for standby time.
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If a third party payer does reimburse for 99360, then see to it that the doctor has documented the standby service with something like: I was requested by [DOCTOR’S NAME] to be on standby for the pacemaker implant performed on [PATIENT’S NAME] on [DATE]. I reached the operating room at [ARRIVAL TIME] and departed at [DEPARTURE TIME].
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Remember: When standby care is requested, both the requesting physician and providing physician must document the need for standby care irrespective of whether a claim for reimbursement is submitted.
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If you submit a claim, see to it that you follow the CPT guidelines for 99360, which include:
• One more doctor must document in writing the request for the standby service.
• The standby doctor must not provide care to other patients during the standby period.
• The standby doctor shouldn’t submit 99360 for any service of less than 30 minutes total on that DOS. You may report an additional unit of 99360 for each additional 30 minutes, which means another full 30 minutes of standby service.
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Tip: If the doctor is called upon during the procedure to place epicardial leads, you should report the code for the service provided rather than reporting 99360

Nikhil Answered Tue 17th of May, 2011 03:27:34 AM

Same rules are mentioned in different sequence with reframed language in many sources of websites; concept and timing of creation of rules being same to what I have mentioned.
Welcome addition of the same concept from a different source, although this content was missing in the first reply.

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