G-code: Procedures and professional services (temporary) Procedures and professional services (temporary)
2,011 codes
Billing context
G-codes are temporary codes for professional services and procedures that would otherwise be coded in CPT.
| Code | Long descriptor | Payment limit (Q4 2026) | Added | Status |
|---|---|---|---|---|
| G9440 | P2y inhibitor not prescribed at discharge | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9441 | Statin prescribed at discharge | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9442 | Statin not prescribed for documented reasons (e.g., allergy, medical intolerance) | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9443 | Statin not prescribed at discharge | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9448 | Patients who were born in the years 1945 to 1965 | — | Jan 1, 2015 | Ended Dec 31, 2021 |
| G9449 | History of receiving blood transfusions prior to 1992 | — | Jan 1, 2015 | Ended Dec 31, 2021 |
| G9450 | History of injection drug use | — | Jan 1, 2015 | Ended Dec 31, 2021 |
| G9451 | Patient received one-time screening for hcv infection | — | Jan 1, 2015 | Ended Dec 31, 2023 |
| G9452 | Documentation of medical reason(s) for not receiving hcv antibody test due to limited life expectancy | — | Jan 1, 2015 | Active |
| G9453 | Documentation of patient reason(s) for not receiving one-time screening for hcv infection (e.g., patient declined, other patient reasons) | — | Jan 1, 2015 | Ended Dec 31, 2023 |
| G9454 | One-time screening for hcv infection not received within 12-month reporting period and no documentation of prior screening for hcv infection, reason not given | — | Jan 1, 2015 | Ended Dec 31, 2023 |
| G9455 | Patient underwent abdominal imaging with ultrasound, contrast enhanced ct or contrast mri for hcc | — | Jan 1, 2015 | Active |
| G9456 | Documentation of medical or patient reason(s) for not ordering or performing screening for hcc. medical reason: comorbid medical conditions with expected survival < 5 years, hepatic decompensation and not a candidate for liver transplantation, or other medical reasons; patient reasons: patient declined or other patient reasons (e.g., cost of tests, time related to accessing testing equipment) | — | Jan 1, 2015 | Active |
| G9457 | Patient did not undergo abdominal imaging and did not have a documented reason for not undergoing abdominal imaging in the submission period | — | Jan 1, 2015 | Active |
| G9458 | Patient documented as tobacco user and received tobacco cessation intervention (must include at least one of the following: advice given to quit smoking or tobacco use, counseling on the benefits of quitting smoking or tobacco use, assistance with or referral to external smoking or tobacco cessation support programs, or current enrollment in smoking or tobacco use cessation program) if identified as a tobacco user | — | Jan 1, 2015 | Ended Dec 31, 2024 |
| G9459 | Currently a tobacco non-user | — | Jan 1, 2015 | Ended Dec 31, 2024 |
| G9460 | Tobacco assessment or tobacco cessation intervention not performed, reason not given | — | Jan 1, 2015 | Ended Dec 31, 2024 |
| G9463 | I intend to report the sinusitis measures group | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9464 | All quality actions for the applicable measures in the sinusitis measures group have been performed for this patient | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9465 | I intend to report the acute otitis externa (aoe) measures group | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9466 | All quality actions for the applicable measures in the aoe measures group have been performed for this patient | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9467 | Patient who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills within the last twelve months | — | Jan 1, 2015 | Ended Dec 31, 2016 |
| G9468 | Patient not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills | — | Jan 1, 2015 | Active |
| G9469 | Patients who have received or are receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 90 or greater consecutive days or a single prescription equating to 900 mg prednisone or greater for all fills | — | Jan 1, 2015 | Ended Dec 31, 2020 |
| G9470 | Patients not receiving corticosteroids greater than or equal to 10 mg/day of prednisone equivalents for 60 or greater consecutive days or a single prescription equating to 600 mg prednisone or greater for all fills | — | Jan 1, 2015 | Active |
| G9471 | Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered or documented | — | Jan 1, 2015 | Active |
| G9472 | Within the past 2 years, central dual-energy x-ray absorptiometry (dxa) not ordered and documented, no review of systems and no medication history or pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed | — | Jan 1, 2015 | Ended Dec 31, 2019 |
| G9473 | Services performed by chaplain in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9474 | Services performed by dietary counselor in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9475 | Services performed by other counselor in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9476 | Services performed by volunteer in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9477 | Services performed by care coordinator in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9478 | Services performed by other qualified therapist in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9479 | Services performed by qualified pharmacist in the hospice setting, each 15 minutes | — | Jan 1, 2016 | Active |
| G9480 | Admission to medicare care choice model program (mccm) | — | Jan 1, 2016 | Active |
| G9481 | Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history; a problem focused examination; and straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9482 | Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: an expanded problem focused history; an expanded problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 20 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9483 | Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate severity. typically, 30 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9484 | Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 45 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9485 | Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 60 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9486 | Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are self limited or minor. typically, 10 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9487 | Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of low to moderate severity. typically, 15 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9488 | Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved cms innovation center demonstration project, which requires at least 2 of the following 3 key components: a detailed history; a detailed examination; medical decision making of moderate complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 25 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9489 | Remote in-home visit for the evaluation and management of an established patient for use only in a medicare-approved coms innovation center demonstration project, which requires at least 2 of the following 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity, furnished in real time using interactive audio and video technology. counseling and coordination of care with other physicians, other qualified health care professionals or agencies are provided consistent with the nature of the problem(s) and the needs of the patient or the family or both. usually, the presenting problem(s) are of moderate to high severity. typically, 40 minutes are spent with the patient or family or both via real time, audio and video intercommunications technology | — | Apr 1, 2016 | Active |
| G9490 | Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/management, compliance with orders/plan of care, performance of activities of daily living, and ensuring beneficiary connections to community and other services. (for use only in medicare-approved cms innovation center models); may not be billed for a 30 day period covered by a transitional care management code | — | Apr 1, 2016 | Active |
| G9496 | Documentation of reason for not detecting adenoma(s) or other neoplasm. (e.g., neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma | — | Jan 1, 2016 | Ended Dec 31, 2017 |
| G9497 | Received instruction from the anesthesiologist or proxy prior to the day of surgery to abstain from smoking on the day of surgery | — | Jan 1, 2016 | Active |
| G9498 | Antibiotic regimen prescribed | — | Jan 1, 2016 | Active |
| G9499 | Patient did not start or is not receiving antiviral treatment for hepatitis c during the measurement period | — | Jan 1, 2016 | Ended Dec 31, 2016 |
| G9500 | Radiation exposure indices documented in final report for procedure using fluoroscopy | — | Jan 1, 2016 | Active |
| G9501 | Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given | — | Jan 1, 2016 | Active |
| G9502 | Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period) | — | Jan 1, 2016 | Active |
| G9503 | Patient taking tamsulosin hydrochloride | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9504 | Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy | — | Jan 1, 2016 | Active |
| G9505 | Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason | — | Jan 1, 2016 | Active |
| G9506 | Biologic immune response modifier prescribed | — | Jan 1, 2016 | Ended Dec 31, 2022 |
| G9507 | Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs) | — | Jan 1, 2016 | Active |
| G9508 | Documentation that the patient is not on a statin medication | — | Jan 1, 2016 | Active |
| G9509 | Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5 | — | Jan 1, 2016 | Active |
| G9510 | Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5 | — | Jan 1, 2016 | Active |
| G9511 | Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period | — | Jan 1, 2016 | Active |
| G9512 | Individual had a pdc of 0.8 or greater | — | Jan 1, 2016 | Active |
| G9513 | Individual did not have a pdc of 0.8 or greater | — | Jan 1, 2016 | Active |
| G9514 | Patient required a return to the operating room within 90 days of surgery | — | Jan 1, 2016 | Active |
| G9515 | Patient did not require a return to the operating room within 90 days of surgery | — | Jan 1, 2016 | Active |
| G9516 | Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery | — | Jan 1, 2016 | Active |
| G9517 | Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given | — | Jan 1, 2016 | Active |
| G9518 | Documentation of active injection drug use | — | Jan 1, 2016 | Active |
| G9519 | Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery | — | Jan 1, 2016 | Active |
| G9520 | Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery | — | Jan 1, 2016 | Active |
| G9521 | Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months | — | Jan 1, 2016 | Active |
| G9522 | Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given | — | Jan 1, 2016 | Active |
| G9523 | Patient discontinued from hemodialysis or peritoneal dialysis | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9524 | Patient was referred to hospice care | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9525 | Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons) | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9526 | Patient was not referred to hospice care, reason not given | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9529 | Patient with minor blunt head trauma had an appropriate indication(s) for a head ct | — | Jan 1, 2016 | Active |
| G9530 | Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider | — | Jan 1, 2016 | Active |
| G9531 | Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar | — | Jan 1, 2016 | Active |
| G9532 | Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than trauma | — | Jan 1, 2016 | Ended Dec 31, 2020 |
| G9533 | Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct | — | Jan 1, 2016 | Active |
| G9534 | Advanced brain imaging (cta, ct, mra or mri) was not ordered | — | Jan 1, 2016 | Ended Dec 31, 2018 |
| G9535 | Patients with a normal neurological examination | — | Jan 1, 2016 | Ended Dec 31, 2018 |
| G9536 | Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms) | — | Jan 1, 2016 | Ended Dec 31, 2018 |
| G9537 | Imaging needed as part of a clinical trial; or other clinician ordered the study | — | Jan 1, 2016 | Active |
| G9538 | Advanced brain imaging (cta, ct, mra or mri) was ordered | — | Jan 1, 2016 | Ended Dec 31, 2018 |
| G9539 | Intent for potential removal at time of placement | — | Jan 1, 2016 | Active |
| G9540 | Patient alive 3 months post procedure | — | Jan 1, 2016 | Active |
| G9541 | Filter removed within 3 months of placement | — | Jan 1, 2016 | Active |
| G9542 | Documented re-assessment for the appropriateness of filter removal within 3 months of placement | — | Jan 1, 2016 | Active |
| G9543 | Documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement | — | Jan 1, 2016 | Active |
| G9544 | Patients that do not have the filter removed, documented re-assessment for the appropriateness of filter removal, or documentation of at least two attempts to reach the patient to arrange a clinical re-assessment for the appropriateness of filter removal within 3 months of placement | — | Jan 1, 2016 | Active |
| G9547 | Cystic renal lesion that is simple appearing (bosniak i or ii) , or adrenal lesion less than or equal to 1.0 cm or adrenal lesion greater than 1.0 cm but less than or equal to 4.0 cm classified as likely benign by unenhanced ct or washout protocol ct, or mri with in- and opposed-phase sequences or other equivalent institutional imaging protocols | — | Jan 1, 2016 | Active |
| G9548 | Final reports for imaging studies stating no follow-up imaging is recommended | — | Jan 1, 2016 | Active |
| G9549 | Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has lymphadenopathy, signs of metastasis or an active diagnosis or history of cancer, and other medical reason(s)) | — | Jan 1, 2016 | Active |
| G9550 | Final reports for imaging studies with follow-up imaging recommended, or final reports that do not include a specific recommendation of no follow-up | — | Jan 1, 2016 | Active |
| G9551 | Final reports for imaging studies without an incidentally found lesion noted | — | Jan 1, 2016 | Active |
| G9552 | Incidental thyroid nodule < 1.0 cm noted in report | — | Jan 1, 2016 | Active |
| G9553 | Prior thyroid disease diagnosis | — | Jan 1, 2016 | Active |
| G9554 | Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended | — | Jan 1, 2016 | Active |