G9268 — Documentation of patient with one or more complications within 90 days
G9268 is a HCPCS Level II code for documentation of patient with one or more complications within 90 days. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2021 and is not valid on new claims.
This code has been terminated
CMS terminated G9268 on December 31, 2021. 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 G9268
- Long descriptor
- Documentation of patient with one or more complications within 90 days
- Short descriptor
- Doc comp or mort w in 90d
- Added
- January 1, 2014
- Terminated
- December 31, 2021
- BETOS
- M5B
- 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 G9268
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9268 is not quite right, the correct code is very often within a few positions of it.
- G9260Documentation of patient death following ceaterminated
- G9261Documentation of patient survival and absence of stroke following ceaterminated
- G9262Documentation of patient death in the hospital following endovascular aaa repairterminated
- G9263Documentation of patient discharged alive following endovascular aaa repairterminated
- G9264Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g., other medical reasons, patient declined arteriovenous fistula (avf)/arteriovenous graft (avg), other patient reasons)terminated
- G9265Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular accessterminated
- G9266Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular accessterminated
- G9267Documentation of patient with one or more complications or mortality within 30 daysterminated
- G9269Documentation of patient without one or more complications and without mortality within 30 daysterminated
- G9270Documentation of patient without one or more complications within 90 daysterminated
- G9271Ldl value < 100terminated
- G9272Ldl value >= 100terminated
- G9273Blood pressure has a systolic value of < 140 and a diastolic value of < 90
- G9274Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
- G9275Documentation that patient is a current non-tobacco user
- G9276Documentation that patient is a current tobacco user
Questions about G9268
What is HCPCS code G9268?
G9268 is a HCPCS Level II code for documentation of patient with one or more complications within 90 days. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9268?
The CMS HCPCS file marks G9268 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 G9268 still valid?
No. G9268 was terminated on December 31, 2021 and should not be used on new claims.