G8597 — Most recent ldl-c >= 100 mg/dl
G8597 is a HCPCS Level II code for most recent ldl-c >= 100 mg/dl. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2014 and is not valid on new claims.
This code has been terminated
CMS terminated G8597 on December 31, 2014. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
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.
The CMS record for G8597
- Long descriptor
- Most recent ldl-c >= 100 mg/dl
- Short descriptor
- Ldl >= 100
- Added
- January 1, 2010
- Terminated
- December 31, 2014
- 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.
When CMS retired it.
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 G8597
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8597 is not quite right, the correct code is very often within a few positions of it.
- G8583Beta-blocker contraindicatedterminated
- G8584No beta-blocker at dischargeterminated
- G8585Anti-lipid treatment at dischargeterminated
- G8586Anti-lipid treatment contraindicatedterminated
- G8587No anti-lipid treatment at dischargeterminated
- G8593Lipid profile results documented and reviewed (must include total cholesterol, hdl-c, triglycerides and calculated ldl-c)terminated
- G8594Lipid profile not performed, reason not giventerminated
- G8595Most recent ldl-c < 100 mg/dlterminated
- G8598Aspirin or another antiplatelet therapy used
- G8599Aspirin or another antiplatelet therapy not used, reason not given
- G8600Iv thrombolytic therapy initiated within 4.5 hours (<= 270 minutes) of time last known well
- G8601Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well for reasons documented by clinician (e.g. patient enrolled in clinical trial for stroke, patient admitted for elective carotid intervention)
- G8602Iv thrombolytic therapy not initiated within 4.5 hours (<= 270 minutes) of time last known well, reason not given
- G8627Surgical procedure performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)terminated
- G8628Surgical procedure not performed within 30 days following cataract surgery for major complications (e.g., retained nuclear fragments, endophthalmitis, dislocated or wrong power iol, retinal detachment, or wound dehiscence)terminated
- G8629Documentation of order for prophylactic parenteral antibiotic to be given within one hour (if fluoroquinolone or vancomycin, two hours) prior to surgical incision (or start of procedure when no incision is required)terminated
Questions about G8597
What is HCPCS code G8597?
G8597 is a HCPCS Level II code for most recent ldl-c >= 100 mg/dl. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8597?
The CMS HCPCS file marks G8597 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.
Is G8597 still valid?
No. G8597 was terminated on December 31, 2014 and should not be used on new claims.