G9531 — Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar
G9531 is a HCPCS Level II code for patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar. 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 G9531
- Long descriptor
- Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar
- Short descriptor
- Pt doc
- Added
- January 1, 2016
- 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 G9531
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9531 is not quite right, the correct code is very often within a few positions of it.
- G9521Total number of emergency department visits and inpatient hospitalizations less than two in the past 12 months
- G9522Total number of emergency department visits and inpatient hospitalizations equal to or greater than two in the past 12 months or patient not screened, reason not given
- G9523Patient discontinued from hemodialysis or peritoneal dialysisterminated
- G9524Patient was referred to hospice careterminated
- G9525Documentation of patient reason(s) for not referring to hospice care (e.g., patient declined, other patient reasons)terminated
- G9526Patient was not referred to hospice care, reason not giventerminated
- G9529Patient with minor blunt head trauma had an appropriate indication(s) for a head ct
- G9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care provider
- G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than traumaterminated
- G9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ct
- G9534Advanced brain imaging (cta, ct, mra or mri) was not orderedterminated
- G9535Patients with a normal neurological examinationterminated
- G9536Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)terminated
- G9537Imaging needed as part of a clinical trial; or other clinician ordered the study
- G9538Advanced brain imaging (cta, ct, mra or mri) was orderedterminated
- G9539Intent for potential removal at time of placement
Questions about G9531
What is HCPCS code G9531?
G9531 is a HCPCS Level II code for patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor, cilostazol, clopidogrel, dipyridamole, eptifibatide, prasugrel, ticlopidine, ticagrelor, tirofiban, or vorapaxar. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9531?
The CMS HCPCS file marks G9531 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 G9531 paid under the physician fee schedule?
G9531 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.