Anesthesia Coding Alert

Question: The obstetrician requested that our anesthesiologist be on standby during the delivery of twins because she was concerned that a cesarean section might be necessary. The anesthesiologist was present for the delivery but did not provide any services. Our anesthesia group is contracted to provide 24-hour in-house coverage at the hospital. Does that affect how (or if) we can bill for physician standby?

Illinois Subscriber

Answer: Assuming the anesthesiologist was on standby for this patient only and wasn't providing services to other patients, report 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]).

On call exclusion: CPT notes state you should not report 99360 for "hospital mandated on call services." That directive keeps providers from billing services otherwise reportable under 99026 (Hospital mandated on call service; in-hospital, each hour) or 99027 (... out-of-hospital, each hour). Working under contract with the hospital does not prevent your providers from coding physician standby service.