How To Use HCPCS Code G0064

HCPCS code G0064 describes a specific service provided by certified nurse midwives. In this article, we will explore the details of this code, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G0064?

HCPCS code G0064 is used to identify the service provided by certified nurse midwives. It is important to note that this code is specific to the MIPS specialty set for certified nurse midwives.

2. Official Description

The official description of HCPCS code G0064 is “Certified nurse midwife MIPS specialty set.” The short description for this code is “Cert nurse midwife ss.”

3. Procedure

1. During the procedure, the certified nurse midwife provides comprehensive healthcare services to women, including prenatal care, labor and delivery support, and postpartum care.
2. They may also provide gynecological care, family planning services, and menopausal management.
3. The certified nurse midwife assesses the patient’s health, performs physical examinations, orders and interprets diagnostic tests, and develops and implements a care plan.
4. They provide counseling and education to patients regarding their healthcare needs and promote wellness and preventive care.
5. Throughout the procedure, the certified nurse midwife collaborates with other healthcare professionals to ensure the best possible outcomes for their patients.

4. When to use HCPCS code G0064

HCPCS code G0064 should be used when billing for the services provided by certified nurse midwives. It is important to ensure that the services meet the criteria set by the MIPS specialty set for certified nurse midwives.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G0064, healthcare providers need to document the services provided by the certified nurse midwife. This documentation should include details of the specific services rendered, the duration of the visit, and any relevant diagnoses or conditions treated. It is important to follow the billing guidelines set by the payer and provide any additional documentation required for reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0064 was added to the Healthcare Common Procedure Coding System on January 01, 2022. As of now, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

The coverage of HCPCS code G0064 may vary depending on the payer. It is important to check with Medicare or other insurance providers to determine if this code is payable. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. The multiple pricing indicator code is 9, indicating that it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G0064 should be billed:

1. A certified nurse midwife provides prenatal care to a pregnant patient, including regular check-ups, monitoring of fetal development, and counseling on healthy pregnancy habits.
2. A certified nurse midwife assists a patient during labor and delivery, providing support, monitoring vital signs, and ensuring a safe and comfortable birthing experience.
3. A certified nurse midwife provides postpartum care to a new mother, including assessing her physical and emotional well-being, providing breastfeeding support, and addressing any concerns or complications.
4. A certified nurse midwife performs a gynecological examination on a patient, including a pelvic exam, Pap smear, and breast examination.
5. A certified nurse midwife provides family planning services to a patient, discussing contraceptive options, providing prescriptions or procedures, and offering counseling on reproductive health.