Question 1

What is HCPCS code M0064?

Accepted Answer

HCPCS code M0064 is "Visit for drug monitoring". Brief office visit for the sole purpose of monitoring or changing drug prescriptions used in the treatment of mental psychoneurotic and personality disorders

Question 2

What category is M0064 in?

Accepted Answer

M0064 belongs to HCPCS Category M (Medical Services).

Question 3

When should I use HCPCS code M0064?

Accepted Answer

Use M0064 when billing for visit for drug monitoring. 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 M0064 covered by Medicare?

Accepted Answer

Coverage for M0064 (Visit for drug monitoring) 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 M0064?

Accepted Answer

Documentation for M0064 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).