tci Medicare Compliance & Reimbursement - 2011 Issue 17

Reader Question: Skip 99360 When Billing to Medicare

Question: My doctors stand by for surgeons in some high-risk procedures/cases. They want to code for their time, and I have found code 99360 for this. Do they need to dictate something in order for me to charge for this?Answer: CMS and many other payers don't pay for 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]), so the physician may not be able to charge for standby time. Some payers might pay on 99360, however. If a third party payer...

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