Question 1

What is HCPCS code G0564?

Accepted Answer

HCPCS code G0564 is "365 d implant glucose sensor". Creation of subcutaneous pocket with insertion of 365 day implantable interstitial glucose sensor, including system activation and patient training

Question 2

What category is G0564 in?

Accepted Answer

G0564 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G0564?

Accepted Answer

Use G0564 when billing for 365 d implant glucose sensor. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is G0564 covered by Medicare?

Accepted Answer

Coverage for G0564 (365 d implant glucose sensor) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for G0564?

Accepted Answer

Documentation for G0564 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).