Take a look at documentation of four areas prior to submitting claims. Also keep an anesthesia code crosswalk handy to assist you in your coding.
CPT's evaluation & management section includes only one code for standby time, however limited choices do not ensure payment. Here are four areas our experts suggest and do not leave your claims hanging in the wings.
You should code based on availability and not care
Your first step in gearing up to submit a claim for standby service is to know what you are reporting and what you are not. Code 99360 doesn't represent patient care, rather it represents availability.
You should document three key factors
Even though CPT includes a standby code, many payers don't reimburse for the service. Comprehensive documentation of your provider's service is key as you might be faced with an appeal. Here are three documentation tips you should heed to when coding 99360 for standby care.
CPT's evaluation & management section includes only one code for standby time, however limited choices do not ensure payment. Here are four areas our experts suggest and do not leave your claims hanging in the wings.
You should code based on availability and not care
Your first step in gearing up to submit a claim for standby service is to know what you are reporting and what you are not. Code 99360 doesn't represent patient care, rather it represents availability.
You should document three key factors
Even though CPT includes a standby code, many payers don't reimburse for the service. Comprehensive documentation of your provider's service is key as you might be faced with an appeal. Here are three documentation tips you should heed to when coding 99360 for standby care.
Know how about the anesthesiologist's involvement in the case.
Check times and locations twice
Being able to report standby service hinges on two more important factors: time and location.
Your anesthesiologist must be in attendance for standby for at least 30 minutes - and he must document that time. According to CPT, if the time is less than half an hour, you do not report it separately. However, it is always a good idea to document patient care whether it is billable or not.
Pay no attention to 99464 for your claims
Some materials that teach about standby coding for labor and delivery (L&D) patients also mention 99464. Even though 99464 goes hand-in-hand with 99360, since it represents newborn care, you will not report 99464 as an anesthesia coder.
Rationale: Anesthesia providers care for the mother and not the baby. The American Society of Anesthesiologists even has policies to this effect. One more provider should be available to offer neonate care, so 99464 applies to that professional.
For further details on this and for other specialty-specific articles to assist your anesthesia coding, sign up for a good medical coding resource like TCI. Such a site comes with products like Anesthesia Analyst that comes with anesthesia code crosswalk to assist your coding.
Check times and locations twice
Being able to report standby service hinges on two more important factors: time and location.
Your anesthesiologist must be in attendance for standby for at least 30 minutes - and he must document that time. According to CPT, if the time is less than half an hour, you do not report it separately. However, it is always a good idea to document patient care whether it is billable or not.
Pay no attention to 99464 for your claims
Some materials that teach about standby coding for labor and delivery (L&D) patients also mention 99464. Even though 99464 goes hand-in-hand with 99360, since it represents newborn care, you will not report 99464 as an anesthesia coder.
Rationale: Anesthesia providers care for the mother and not the baby. The American Society of Anesthesiologists even has policies to this effect. One more provider should be available to offer neonate care, so 99464 applies to that professional.
For further details on this and for other specialty-specific articles to assist your anesthesia coding, sign up for a good medical coding resource like TCI. Such a site comes with products like Anesthesia Analyst that comes with anesthesia code crosswalk to assist your coding.
