Stand-by Services

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January 23, 2014

Question:  

What is the right code and way to document a stand by tracheostomy? Here’s a clinical scenario… 70 y/o woman comes in to the ER with tongue swelling, she has respiratory distress needs intubation. I get called in to stand by while the anesthesiologist performs an intubation. I will need to perform a tracheostomy if the intubation fails. No trach needed. I just watched the anesthesiologist intubate the patient. No intervention from my part. What code should I use for this procedure? What is the reimbursement?

Answer:

The standby code 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). You may bill 1 unit of this code for each 30 minutes of standby. Unfortunately, Medicare does not reimburse this code but some of your other payors might.