HCPCS G-Codes
Procedures/Professional Services (Temporary Codes)

Temporary G codes are assigned to services and procedures that are under review before being included in the CPT coding system. Payment for these services is under the jurisdiction of the local carriers.

• 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)

• G9503

  Patient taking tamsulosin hydrochloride

• 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

• G9505

  Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason

• G9506

  Biologic immune response modifier prescribed

• 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)

• G9508

  Documentation that the patient is not on a statin medication

• 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

• 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

• G9511

  Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period

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  Continued

• G9512

  Individual had a pdc of 0.8 or greater

• G9513

  Individual did not have a pdc of 0.8 or greater

• G9514

  Patient required a return to the operating room within 90 days of surgery

• G9515

  Patient did not require a return to the operating room within 90 days of surgery

• G9516

  Patient achieved an improvement in visual acuity, from their preoperative level, within 90 days of surgery

• G9517

  Patient did not achieve an improvement in visual acuity, from their preoperative level, within 90 days of surgery, reason not given

• G9518

  Documentation of active injection drug use

• G9519

  Patient achieves final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

• G9520

  Patient does not achieve final refraction (spherical equivalent) +/- 1.0 diopters of their planned refraction within 90 days of surgery

• G9521

  Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months

• 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

• G9523

  Patient discontinued from hemodialysis or peritoneal dialysis

• G9524

  Patient was referred to hospice care

• G9525

  Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)

• G9526

  Patient was not referred to hospice care, reason not given

• G9529

  Patient with minor blunt head trauma had an appropriate indication(s) for a head ct

• G9530

  Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider

• 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

• 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

• G9533

  Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct

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  Continued

• G9534

  Advanced brain imaging (cta, ct, mra or mri) was not ordered

• G9535

  Patients with a normal neurological examination

• 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)

• G9537

  Imaging needed as part of a clinical trial; or other clinician ordered the study

• G9538

  Advanced brain imaging (cta, ct, mra or mri) was ordered

• G9539

  Intent for potential removal at time of placement

• G9540

  Patient alive 3 months post procedure

• G9541

  Filter removed within 3 months of placement

• G9542

  Documented re-assessment for the appropriateness of filter removal within 3 months of placement

• 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

• 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

• 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

• G9548

  Final reports for imaging studies stating no follow-up imaging is recommended

• 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))

• 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

• G9551

  Final reports for imaging studies without an incidentally found lesion noted

• G9552

  Incidental thyroid nodule < 1.0 cm noted in report

• G9553

  Prior thyroid disease diagnosis

• G9554

  Final reports for ct, cta, mri or mra of the chest or neck with follow-up imaging recommended

• G9555

  Documentation of medical reason(s) for recommending follow up imaging (e.g., patient has multiple endocrine neoplasia, patient has cervical lymphadenopathy, other medical reason(s))