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: One of my surgeons wants to charge standby services (99360) for the time he has to wait while a frozen section is sent to pathology. Is this allowed? Colorado Subscriber


Answer: The use of standby 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 not appropriate in this case. Although the descriptor for 99360 mentions "standby for frozen section," CPT rules specify three requirements for reporting standby services:
1. Another provider must request the service.
2. The service is not face-to-face with the patient.
3. Standby services cannot be used with procedures that involve a global period. Specifically, CPT instructs, "It [99360] is not used if the period of standby ends with the performance of a procedure subject to a 'surgical' package by the physician who was on standby." In this case, the surgeon awaiting the pathology report is also operating on the patient (that is, he is providing a procedure with a global surgical package), and therefore the time he spends awaiting the report is "bundled to" the surgical procedure and not separately billable with 99360 or any other code. More appropriately, a surgeon may report 99360 if a second surgeon asks him to standby during an especially difficult surgery in case additional help is needed. In this case, the surgeon providing standby services may report a single unit of 99360 only after 30 minutes have passed (standby services of less than 30 minutes are not reportable). Likewise, he may report a second unit of 99360 only after an additional 30 minutes has passed. For example, you should report 85 minutes of standby time as 99360 x 2, whereas you can bill 95 minutes of standby time with 99360 x 3.