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ASH527

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My physician/surgeon provided Standby services for another Surgeon different specialty different group practice. I billed for 99360 and was denied included in global procedure -
Any thoughts on why & how I could get this paid. My surgeon was in the operating room & performed no surgical services. I had billed for 4 units of procedure code 99360

Any help is appreciated.

Thanks
 
I think in general, many insurance companies including Medicare do not pay for the stand by services.

If the denial is simply not a covered service, I don't think there is nothing you can do. Just nature of the beast.

But otherwise, I would submit documentation and an appeal.

Does your documentation from the provider on standby say something like, " I was asked by provider A to be on stand by for patient A during certain medical procedure. I was on standby from 10am to 1pm. I did not perform any type of procedure.

Just my thoughts. Good Luck.
 
Did you look at modifier 81? This is applied to the surgical code. I am not certain a standby in the OR meets this definition but you should look at it.
 
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