Cardiology Coding: No Medicare Pay For 99360

By Author: erinarticle
Total Articles: 105
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My physicians stand by for the cardiologist during a pacemaker placement case they need to place epicardial leads. They want to code for their time, and I’ve found code 99360 for this. Is it necessary that they dictate something so that I can charge for this?


CMS and many other payers do not pay for 99360 (Physician standby service, requiring prolonged physician attendance [face-to face] without direct patient contact, each 30 minutes [example., operative standby, standby for frozen section, for cesarean/high risk delivery, for monitoring EEG]), so that the doctor may not be able to charge for standby time.


If a third party payer does reimburse for 99360, then see to it that the doctor has documented the standby service with something like: I was requested by [DOCTOR’S NAME] to be on standby for the pacemaker implant performed on [PATIENT’S NAME] on [DATE]. I reached the operating room at [ARRIVAL TIME] and departed at [DEPARTURE TIME].


Remember: When standby care is requested, both the requesting physician and providing physician must document the need ...
... for standby care irrespective of whether a claim for reimbursement is submitted.


If you submit a claim, see to it that you follow the CPT guidelines for 99360, which include:


One more doctor must document in writing the request for the standby service.


The standby doctor must not provide care to other patients during the standby period.


The standby doctor shouldn’t submit 99360 for any service of less than 30 minutes total on that DOS. You may report an additional unit of 99360 for each additional 30 minutes, which means another full 30 minutes of standby service.


Tip: If the doctor is called upon during the procedure to place epicardial leads, you should report the code for the service provided rather than reporting 99360.


For more on this and for other specialty-specific articles to assist your cardiology coding, sign up for a good medical coding resource like Coding Institute.