G9431 — Pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
G9431 is a HCPCS Level II code for pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors. 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
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G9431
- Long descriptor
- Pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
- Short descriptor
- Patho rpt no pt ctg
- Added
- January 1, 2015
- BETOS
- Z2
- 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 G9431
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9431 is not quite right, the correct code is very often within a few positions of it.
- G9423Documentation of medical reason for not including pt category, pn category and histologic type [for patient with appropriate exclusion criteria (e.g., metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]
- G9424Specimen site other than anatomic location of lung, or classified as nsclc-nos
- G9425Primary lung carcinoma resection report does not document pt category, pn category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma)
- G9426Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration performed for ed admitted patients
- G9427Improvement in median time from ed arrival to initial ed oral or parenteral pain medication administration not performed for ed admitted patients
- G9428Pathology report includes the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors
- G9429Documentation of medical reason(s) for not including pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors (e.g., negative skin biopsies, insufficient tissue, or other documented medical reasons)
- G9430Specimen site other than anatomic cutaneous location
- G9432Asthma well-controlled based on the act, c-act, acq, or ataq score and results documented
- G9433Death, permanent nursing home resident or receiving hospice or palliative care any time during the measurement periodterminated
- G9434Asthma not well-controlled based on the act, c-act, acq, or ataq score, or specified asthma control tool not used, reason not given
- G9435Aspirin prescribed at dischargeterminated
- G9436Aspirin not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)terminated
- G9437Aspirin not prescribed at dischargeterminated
- G9438P2y inhibitor prescribed at dischargeterminated
- G9439P2y inhibitor not prescribed for documented reasons (e.g., allergy, medical intolerance, history of bleed)terminated
Questions about G9431
What is HCPCS code G9431?
G9431 is a HCPCS Level II code for pathology report does not include the pt category, thickness, ulceration and mitotic rate, peripheral and deep margin status and presence or absence of microsatellitosis for invasive tumors. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9431?
The CMS HCPCS file marks G9431 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 G9431 paid under the physician fee schedule?
G9431 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.