• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Prolonged visit

Create Wiki
A

ASH527

Guru
Messages
148
Location
Williamsburg, MA
Best answers
0
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.
 
You must log in or register to reply here.
Top