G9999 — Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)
G9999 is a HCPCS Level II code for documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete). 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 G9999
- Long descriptor
- Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)
- Short descriptor
- Doc sys rsn <3 colon
- Added
- January 1, 2022
- 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 G9999
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9999 is not quite right, the correct code is very often within a few positions of it.
- G9991Patient received any pneumococcal conjugate or polysaccharide vaccine on or after their 19th birthday and before the end of the measurement periodterminated
- G9992Palliative care services used by patient any time during the measurement period
- G9993Patient was provided palliative care services any time during the measurement period
- G9994Patient is using palliative care services any time during the measurement period
- G9995Patients who use palliative care services any time during the measurement periodterminated
- G9996Documentation stating the patient has received or is currently receiving palliative or hospice care
- G9997Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter
- G9998Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])
- H0001Alcohol and/or drug assessment
- H0002Behavioral health screening to determine eligibility for admission to treatment program
- H0003Alcohol and/or drug screening; laboratory analysis of specimens for presence of alcohol and/or drugs
- H0004Behavioral health counseling and therapy, per 15 minutes
- H0005Alcohol and/or drug services; group counseling by a clinician
- H0006Alcohol and/or drug services; case management
- H0007Alcohol and/or drug services; crisis intervention (outpatient)
- H0008Alcohol and/or drug services; sub-acute detoxification (hospital inpatient)
Questions about G9999
What is HCPCS code G9999?
G9999 is a HCPCS Level II code for documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9999?
The CMS HCPCS file marks G9999 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 G9999 paid under the physician fee schedule?
G9999 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.