HCPCS Code G8938

Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible
Code effective Jan 01, 2022

HCPCS Section
Procedures/Professional Services (Temporary Codes)

G8938 is a valid 2026 HCPCS code meaning Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible or (Bmi doc onl fup nt doc) for short. HCPCS G8938 has been effective since 01/01/2022 and applies to Medical care.

HCPCS Code Details - G8938

HCPCS Level II Code
Section G - Procedures/Professional Services (Temporary Codes)
HCPCS Code G8938
Description

Long description:
Bmi is documented as being outside of normal parameters, follow-up plan is not documented, documentation the patient is not eligible

Short description:
Bmi doc onl fup nt doc

HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code C - Carrier judgment
BETOS2 code M5B - Specialist - psychiatry
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2022
Date added Added Jan 01, 2013
Termination date Dec 31, 2021

See also

  • HCPCS G8937 · Clinician did not prescribe angiotensin converting enzyme (ace) inhibitor or angiotensin receptor blocker (arb) therapy, reason not given

  • HCPCS G8417 · Bmi is documented above normal parameters and a follow-up plan is documented

  • HCPCS G8418 · Bmi is documented below normal parameters and a follow-up plan is documented

  • HCPCS G8420 · Bmi is documented within normal parameters and no follow-up plan is required

  • HCPCS G9716 · Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason

  • HCPCS M1286 · Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason

  • HCPCS M1287 · Bmi is documented below normal parameters and a follow-up plan is documented

  • HCPCS M1293 · Bmi is documented above normal parameters and a follow-up plan is documented

  • HCPCS M1296 · Bmi is documented within normal parameters and no follow-up plan is required

  • HCPCS G8939 · Pain assessment documented as positive, follow-up plan not documented, documentation the patient is not eligible at the time of the encounter

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/23/2026

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