Anesthesia Coding Alert

Question: How should I bill anesthesia for a patient of extreme age, and anesthesia complicated by an emergency condition? Should I add extra units for these circumstances to the procedure's base units, or should I bill them separately? Virginia Subscriber Answer: The code for billing stand-by service is 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]).

As noted in the CPT comments preceding the code, the physician "may not be providing care or services to other patients during this period." Standby service is billed in 30-minute increments, with partial time units rounded down. Most offices do not bill for the service if it is less than 30 minutes, and you do not bill standby time if the physician goes on to provide actual care to the patient. The anesthesiologist does not need to have patient contact in order to bill standby, but the patient's record should document that the obstetrician requested the service, and the anesthesiologist should note his presence and the start and stop times of standby.