G9716 — Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
G9716 is a HCPCS Level II code for bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason. 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
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The CMS record for G9716
- Long descriptor
- Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason
- Short descriptor
- Bmi doc onl fup not cmpltd
- Added
- January 1, 2017
- 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 G9716
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9716 is not quite right, the correct code is very often within a few positions of it.
- G9708Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
- G9709Hospice services used by patient any time during the measurement period
- G9710Patient was provided hospice services any time during the measurement period
- G9711Patients with a diagnosis or past history of total colectomy or colorectal cancer
- G9712Documentation of medical reason(s) for prescribing or dispensing antibiotic (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis/ mastoiditis/bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia, gonococcal infections/venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis
- G9713Patients who use hospice services any time during the measurement period
- G9714Patient is using hospice services any time during the measurement period
- G9715Patients who use hospice services any time during the measurement periodterminated
- G9717Documentation stating the patient has had a diagnosis of bipolar disorder
- G9718Hospice services for patient provided any time during the measurement periodterminated
- G9719Patient is not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
- G9720Hospice services for patient occurred any time during the measurement period
- G9721Patient not ambulatory, bed ridden, immobile, confined to chair, wheelchair bound, dependent on helper pushing wheelchair, independent in wheelchair or minimal help in wheelchair
- G9722Documented history of renal failure or baseline serum creatinine >= 4.0 mg/dl; renal transplant recipients are not considered to have preoperative renal failure, unless, since transplantation the cr has been or is 4.0 or higher
- G9723Hospice services for patient received any time during the measurement period
- G9724Patients who had documentation of use of anticoagulant medications overlapping the measurement year
Questions about G9716
What is HCPCS code G9716?
G9716 is a HCPCS Level II code for bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9716?
The CMS HCPCS file marks G9716 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 G9716 paid under the physician fee schedule?
G9716 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.