Question 1

What is HCPCS code G9964?

Accepted Answer

HCPCS code G9964 is "Pt recv >=1 well-chld visit". Patient received at least one well-child visit with a pcp during the performance period

Question 2

What category is G9964 in?

Accepted Answer

G9964 belongs to HCPCS Category G (Procedures/Professional Services).

Question 3

When should I use HCPCS code G9964?

Accepted Answer

Use G9964 when billing for pt recv >=1 well-chld visit. 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 G9964 covered by Medicare?

Accepted Answer

Coverage for G9964 (Pt recv >=1 well-chld visit) 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 G9964?

Accepted Answer

Documentation for G9964 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).