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.

• G9176

  Other speech language pathology functional limitation, discharge status at discharge from therapy or to end reporting

• G9186

  Motor speech functional limitation, projected goal status at therapy episode outset, at reporting intervals, and at discharge or to end reporting

• G9187

  Bundled payments for care improvement initiative home visit for patient assessment performed by a qualified health care professional for individuals not considered homebound including, but not limited to, assessment of safety, falls, clinical status, fluid status, medication reconciliation/management, patient compliance with orders/plan of care, performance of activities of daily living, appropriateness of care setting; (for use only in the meidcare-approved bundled payments for care improvement initiative); may not be billed for a 30-day period covered by a transitional care management code

• G9188

  Beta-blocker therapy not prescribed, reason not given

• G9189

  Beta-blocker therapy prescribed or currently being taken

• G9190

  Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)

• G9191

  Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)

• G9192

  Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)

• G9193

  Clinician documented that patient with a diagnosis of major depression was not an eligible candidate for antidepressant medication treatment or patient did not have a diagnosis of major depression

• G9194

  Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 180 day (6 month) continuation treatment phase

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  Continued

• G9195

  Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 180 day (6 months) continuation treatment phase

• G9196

  Documentation of medical reason(s) for not ordering a first or second generation cephalosporin for antimicrobial prophylaxis (e.g., patients enrolled in clinical trials, patients with documented infection prior to surgical procedure of interest, patients who were receiving antibiotics more than 24 hours prior to surgery [except colon surgery patients taking oral prophylactic antibiotics], patients who were receiving antibiotics within 24 hours prior to arrival [except colon surgery patients taking oral prophylactic antibiotics], other medical reason(s))

• G9197

  Documentation of order for first or second generation cephalosporin for antimicrobial prophylaxis

• G9198

  Order for first or second generation cephalosporin for antimicrobial prophylaxis was not documented, reason not given

• G9199

  Venous thromboembolism (vte) prophylaxis not administered the day of or the day after hospital admission for documented reasons (eg, patient is ambulatory, patient expired during inpatient stay, patient already on warfarin or another anticoagulant, other medical reason(s) or eg, patient left against medical advice, other patient reason(s))

• G9200

  Venous thromboembolism (vte) prophylaxis was not administered the day of or the day after hospital admission, reason not given

• G9201

  Venous thromboembolism (vte) prophylaxis administered the day of or the day after hospital admission

• G9202

  Patients with a positive hepatitis c antibody test

• G9203

  Rna testing for hepatitis c documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c

• G9204

  Rna testing for hepatitis c was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given

• G9205

  Patient starting antiviral treatmentfor hepatitis c during the measurement period

• G9206

  Patient starting antiviral treatment for hepatitis c during the measurement period

• G9207

  Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c

• G9208

  Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given

• G9209

  Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment

• G9210

  Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)

• G9211

  Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given

• G9212

  Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation

• G9213

  Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified

• G9214

  Cd4+ cell count or cd4+ cell percentage results documented

• ---

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  Continued

• G9215

  Cd4+ cell count or percentage not documented as performed, reason not given

• G9216

  Pcp prophylaxis was not prescribed at time of diagnosis of hiv, reason not given

• G9217

  Pcp prophylaxis was not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3, reason not given

• G9218

  Pcp prophylaxis was not prescribed within 3 months oflow cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%, reason not given

• G9219

  Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 200 cells/mm3 for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

• G9220

  Pneumocystis jiroveci pneumonia prophylaxis not prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15% for medical reason (i.e., patient's cd4+ cell count above threshold within 3 months after cd4+ cell count below threshold, indicating that the patient's cd4+ levels are within an acceptable range and the patient does not require pcp prophylaxis)

• G9221

  Pneumocystis jiroveci pneumonia prophlaxis prescribed

• G9222

  Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3

• G9223

  Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%

• G9224

  Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)

• G9225

  Foot exam was not performed, reason not given

• G9226

  Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)

• G9227

  Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter

• G9228

  Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)

• G9229

  Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)

• G9230

  Chlamydia, gonorrhea, and syphilis not screened, reason not given

• G9231

  Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period

• G9232

  Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)

• G9233

  All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient

• G9234

  I intend to report the total knee replacement measures group