How To Use HCPCS Code G4024

HCPCS code G4024 describes a specific set of services within the field of pediatrics. This code is used to identify the Pediatrics MIPS Specialty Set, which is designed to measure and assess the quality of care provided to pediatric patients. In this article, we will explore the details of HCPCS code G4024, 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 G4024?

HCPCS code G4024 is used to identify the Pediatrics MIPS Specialty Set. This set of services is specifically tailored to measure and assess the quality of care provided to pediatric patients. It is important for healthcare providers to accurately use this code when reporting services related to the Pediatrics MIPS Specialty Set.

2. Official Description

The official description of HCPCS code G4024 is “Pediatrics MIPS Specialty Set.” The short description for this code is “Pediatrics ss.” These descriptions accurately reflect the purpose and scope of this code.

3. Procedure

1. Providers should follow the guidelines and criteria set forth by the Pediatrics MIPS Specialty Set when delivering care to pediatric patients.
2. Ensure that all necessary documentation and data are collected to support the reporting of services related to the Pediatrics MIPS Specialty Set.
3. Submit claims using HCPCS code G4024 to accurately identify the services provided within the Pediatrics MIPS Specialty Set.

4. When to use HCPCS code G4024

HCPCS code G4024 should be used when reporting services that fall within the scope of the Pediatrics MIPS Specialty Set. This code is specifically designed for pediatric care and should only be used in contexts where the services provided align with the requirements and guidelines of the Pediatrics MIPS Specialty Set.

5. Billing Guidelines and Documentation Requirements

When billing for services using HCPCS code G4024, healthcare providers should ensure that all necessary documentation is in order. This includes but is not limited to:

• Complete and accurate medical records that support the services provided within the Pediatrics MIPS Specialty Set.
• Documentation of any relevant diagnoses, treatments, or procedures performed.
• Any additional documentation required by payers or regulatory bodies.

Providers should also follow the billing guidelines set forth by the Centers for Medicare and Medicaid Services (CMS) and other relevant insurance carriers to ensure proper reimbursement for services rendered.

6. Historical Information and Code Maintenance

HCPCS code G4024 was added to the Healthcare Common Procedure Coding System on January 01, 2022. As of its addition, 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 suggests that the code is still relatively new and has not undergone any significant updates or revisions since its addition.

7. Medicare and Insurance Coverage

The pricing indicator code for HCPCS code G4024 is 00, which indicates that the service is not separately priced by Part B. This means that the service is likely bundled or not covered by Medicare or other insurers. The multiple pricing indicator code is 9, which signifies that the value for this code is not established or not applicable. Providers should consult with Medicare and other insurance carriers to determine the coverage and reimbursement policies for services related to the Pediatrics MIPS Specialty Set.

8. Examples

Here are five examples of when HCPCS code G4024 should be billed:

1. A pediatrician performs a comprehensive well-child visit for a 2-year-old patient, including developmental screening, immunizations, and counseling on nutrition and safety.
2. A pediatric specialist conducts a complex evaluation and management visit for a child with a chronic medical condition, involving a detailed history, examination, and medical decision-making.
3. A pediatric nurse practitioner provides education and counseling to parents on managing common childhood illnesses and promoting healthy habits.
4. A pediatric occupational therapist delivers therapy sessions to a child with developmental delays, focusing on improving fine motor skills and sensory integration.
5. A pediatric speech-language pathologist conducts a comprehensive evaluation and provides ongoing therapy for a child with speech and language disorders.