G9675 — Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
G9675 is a HCPCS Level II code for patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl. 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 G9675
- Long descriptor
- Patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl
- Short descriptor
- Pt w/fast/dir lab ldl-c >190
- 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 G9675
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9675 is not quite right, the correct code is very often within a few positions of it.
- G9666Patient's highest fasting or direct ldl-c laboratory test result in the measurement period or two years prior to the beginning of the measurement period is 70-189 mg/dlterminated
- G9667Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)terminated
- G9669I intend to report the multiple chronic conditions measures groupterminated
- G9670All quality actions for the applicable measures in the multiple chronic conditions measures group have been performed for this patientterminated
- G9671I intend to report the diabetic retinopathy measures groupterminated
- G9672All quality actions for the applicable measures in the diabetic retinopathy measures group have been performed for this patientterminated
- G9673I intend to report the cardiovascular prevention measures groupterminated
- G9674Patients with clinical ascvd diagnosis
- G9676Patients aged 40 to 75 years at the beginning of the measurement period with type 1 or type 2 diabetes and with an ldl-c result of 70-189 mg/dl recorded as the highest fasting or direct laboratory test result in the measurement year or during the two years prior to the beginning of the measurement period
- G9677All quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patientterminated
- G9678Oncology care model (ocm) monthly enhanced oncology services (meos) payment for ocm enhanced services. g9678 payments may only be made to ocm practitioners for ocm beneficiaries for the furnishment of enhanced services as defined in the ocm participation agreementterminated
- G9679This code is for onsite acute care treatment of a nursing facility resident with pneumonia; may only be billed once per day per beneficiary
- G9680This code is for onsite acute care treatment of a nursing facility resident with chf; may only be billed once per day per beneficiary
- G9681This code is for onsite acute care treatment of a resident with copd or asthma; may only be billed once per day per beneficiary
- G9682This code is for the onsite acute care treatment a nursing facility resident with a skin infection; may only be billed once per day per beneficiary
- G9683Facility service(s) for the onsite acute care treatment of a nursing facility resident with fluid or electrolyte disorder. (may only be billed once per day per beneficiary). this service is for a demonstration project
Questions about G9675
What is HCPCS code G9675?
G9675 is a HCPCS Level II code for patients who have ever had a fasting or direct laboratory result of ldl-c = 190 mg/dl. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9675?
The CMS HCPCS file marks G9675 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 G9675 paid under the physician fee schedule?
G9675 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.