Anesthesia Coding Alert

Question: One of our anesthesiologists was requested to be on standby for a cardiologist who was performing a coronary angiogram. The physician wanted him there in case an emergency occurred and he would be needed to induce the patient. Nothing happened though. How do I code for the time he was on standby?

Florida Subscriber

Answer: The E/M section of CPT shows only one code for standby time: 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]). This code only represents availability, however, not patient care. You can report standby service for this case, but since many payers do not reimburse for this service, you will need to include supporting documentation and adhere to the following guidelines:

1. You cannot report standby services if your physician is already on-call, if he is medically directing other cases, or if he is proctoring another physician during the same time.

2. Another physician or CRNA (certified registered nurse anesthetist) must request that your anesthesiologist make himself available for standby time. You need this request in writing, along with justification for why the other physician requests anesthesia standby.

3. The chart should include a note by the anesthesiologist  documenting that his service would be helpful.

4. Your anesthesiologist must be in attendance for standby for at least 30 minutes -- and he must document that time.

5. You must include information about the anesthesiologist's involvement in the case.