G8430 — Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status)
G8430 is a HCPCS Level II code for documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status). It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
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The CMS record for G8430
- Long descriptor
- Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status)
- Short descriptor
- Doc med rsn no medrec
- Added
- January 1, 2008
- BETOS
- M5D
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8430
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8430 is not quite right, the correct code is very often within a few positions of it.
- G8417Bmi is documented above normal parameters and a follow-up plan is documented
- G8418Bmi is documented below normal parameters and a follow-up plan is documented
- G8419Bmi documented outside normal parameters, no follow-up plan documented, no reason given
- G8420Bmi is documented within normal parameters and no follow-up plan is required
- G8421Bmi not documented and no reason is given
- G8422Bmi not documented, documentation the patient is not eligible for bmi calculationterminated
- G8427Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications
- G8428Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given
- G8431Screening for depression is documented as being positive and a follow-up plan is documented
- G8432Depression screening not documented, reason not given
- G8433Screening for depression not completed, documented patient or medical reason
- G8442Pain assessment not documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool at the time of the encounterterminated
- G8450Beta-blocker therapy prescribed
- G8451Beta-blocker therapy for lvef <=40% not prescribed for reasons documented by the clinician (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons, patient declined, other patient reasons)
- G8452Beta-blocker therapy not prescribed
- G8458Clinician documented that patient is not an eligible candidate for genotype testing; patient not receiving antiviral treatment for hepatitis c during the measurement period (e.g. genotype test done prior to the reporting period, patient declines, patient not a candidate for antiviral treatment)terminated
Questions about G8430
What is HCPCS code G8430?
G8430 is a HCPCS Level II code for documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8430?
The CMS HCPCS file marks G8430 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is G8430 paid under the physician fee schedule?
G8430 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.