How To Use HCPCS Code G0065

HCPCS code G0065 describes a specific service within the field of chiropractic medicine. This code is used to identify chiropractic services provided by healthcare providers who specialize in this area. In this article, we will explore the details of HCPCS code G0065, 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 G0065?

HCPCS code G0065 is a unique alphanumeric code that is used to identify a specific service within the field of chiropractic medicine. This code is specifically related to chiropractic services and is used to indicate the type of service provided by a healthcare provider.

2. Official Description

The official description of HCPCS code G0065 is “Chiropractic medicine mips specialty set.” The short description for this code is “Chiropractic ss.” These descriptions provide a general overview of the service that is being identified by this code.

3. Procedure

1. When providing chiropractic services using HCPCS code G0065, the healthcare provider will first assess the patient’s condition and determine the appropriate treatment plan.
2. The provider will then perform various chiropractic techniques, such as spinal adjustments, manipulations, and other manual therapies, to address the patient’s specific needs.
3. Throughout the procedure, the provider will carefully evaluate the patient’s response to the treatment and make any necessary adjustments to ensure optimal results.
4. After the procedure is complete, the provider may provide the patient with additional instructions for at-home care or recommend follow-up appointments as needed.

4. When to use HCPCS code G0065

HCPCS code G0065 should be used when billing for chiropractic services that fall within the scope of this code. It is important to note that this code is specific to chiropractic medicine and should not be used for services provided by other healthcare specialties.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G0065, healthcare providers should ensure that they have proper documentation to support the services provided. This may include detailed notes on the patient’s condition, the treatment plan, and the specific procedures performed during the visit. It is also important to follow any billing guidelines set forth by the payer, such as Medicare or private insurance companies, to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code G0065 was added to the Healthcare Common Procedure Coding System on January 01, 2022. As of the effective date, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code is relatively new and does not have a significant historical context or any notable changes since its addition.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G0065 may vary depending on the specific payer and the patient’s individual plan. It is important for healthcare providers to verify coverage and reimbursement policies with the payer before providing services. The pricing indicator code for this code is 00, which indicates that the service is not separately priced by Part B. This means that the service may be bundled or not covered by Medicare or other insurers.

8. Examples

Here are five examples of scenarios where HCPCS code G0065 may be billed:

1. A patient presents with chronic back pain and seeks chiropractic treatment. The provider performs spinal adjustments and manual therapies to alleviate the pain. HCPCS code G0065 is used to bill for the services.
2. A patient with a sports injury visits a chiropractor for treatment. The provider uses various techniques, such as joint mobilization and soft tissue therapies, to address the injury. HCPCS code G0065 is used to bill for the services.
3. A pregnant patient seeks chiropractic care to manage discomfort and promote optimal alignment during pregnancy. The provider performs gentle adjustments and provides guidance on exercises and stretches. HCPCS code G0065 is used to bill for the services.
4. A patient with a history of migraines visits a chiropractor for treatment. The provider performs adjustments and provides recommendations for lifestyle modifications to help manage the migraines. HCPCS code G0065 is used to bill for the services.
5. A patient with a musculoskeletal condition, such as scoliosis, receives ongoing chiropractic care to manage their condition. The provider performs regular adjustments and monitors the patient’s progress. HCPCS code G0065 is used to bill for the services.