General Surgery Coding Alert

Test your coding knowledge.  Determine how you would code this situation before looking at the box below for the answer.
Question: As a vascular surgeon, I am often asked to be available to assist other surgeons during a procedure that might involve mobilization or repair of vascular structures. Is it correct to use 99360 for these circumstances? Is the same code used for each additional 30 minutes? Is there a limit to the number of 30-minute intervals that can be reported for one clinical situation?

Pennsylvania Subscriber

Answer: Code 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]) is correct in this situation, but most carriers do not pay for this service, which has not been assigned any relative value units in the CMS fee schedule.
 
To meet the criteria for reporting 99360, the surgeon cannot be in the physician's lounge or providing services to another patient. He or she must be scrubbed and in the operating room.
 
Because standby services are billed according to time (in 30-minute segments), the time spent by the surgeon also needs to be documented in the patient's chart, as follows: "Dr. ______ was standing by for xx minutes."    

According to CPT, "Standby service of less than 30 minutes total duration on a given date is not reported separately. Second and subsequent periods of standby beyond the first 30 minutes may be reported only if a full 30 minutes of standby was provided for each unit of service reported." The manual lists no limit to the units of 99360 that may be claimed.