subject: 99360 Is Payable Provided You Follow the Rules [print this page] 99360 Is Payable Provided You Follow the Rules
CPT's E/M section includes only one code for standby time. However limited choices does not ensure payment. Here are four areas to help you avoid leaving your claims hanging in the wings.
Code based on availability, not care Your first step in gearing up to submit a claim for standby service is to know what you are reporting and what you are not. Code 99360 does not represent patient care rather, it represents availability.
Document three important factors Even though CPT includes a standby code, many payers don't reimburse for the service. Thorough documentation of your provider's service is paramount as you might be faced with an appeal.
Double check times and locations Being able to report standby service depends on two more important factors: time and location. Your anesthesiologist must be in attendance for standby for at least 30 minutes and he must document that time. According to CPT, if the time is less than 30 minutes, you shouldn't report it separately. But then it is always a good idea to document patient care whether it is billable or not.
Ignore 99464 for your claims Some materials that teach about standby coding for labor and delivery (L&D) patients also mention 99464. Even though 99464 goes hand-in-hand with 99360 as it represents newborn care, you won't report 99464 as an anesthesia coder. Rationale: Anesthesia providers care for the mother, and not the baby. The American Society of Anesthesiologists has policies to this effect too. Another provider should be available to offer neonate care; as such 99464 applies to that professional. For more on this and all 2011 CPT updates, sign up for a medical coding guide like Supercoder.
welcome to Insurances.net (https://www.insurances.net)
