Angelica Posted Thu 02nd of July, 2020 12:14:32 PM
I work for an anesthesiologist group in Texas our Medicare carrier is Novitas. Anesthesia was asked to be on standby for a cash pay stem cell injection procedure. During the procedure anesthesia services were not needed. Are we able to bill anything for the standby time?
SuperCoder Answered Fri 03rd of July, 2020 08:09:33 AM
Thank you for your question.
CMS and many other payers don't pay for 99360 (Physician standby service, requiring prolonged physician attendance, each 30 minutes [e.g., operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring EEG]), so the physician may not be able to charge for standby time.
Some payers might pay on 99360, however. If a third party payer does reimburse for 99360, then 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 trauma surgery performed on [PATIENT'S NAME] on [DATE]. I arrived at the facility at [ARRIVAL TIME] and departed at [DEPARTURE TIME].
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.
If you submit a claim, be sure to follow the CPT® guidelines for 99360, which include:
Another physician must document in writing the request for the standby service
The standby physician must not provide care to other patients during the standby period
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.