G9998 Documentation 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])
Short descriptor: Doc med rsn <3 colon
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G9998 is the HCPCS Level II code for Documentation 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]) (2026). It belongs to Section G — Procedures / Professional Services (Temporary). Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Not separately priced by Part B.
Classification & CMS Attributes
- Medicare Coverage
- Carrier judgment (code C)
- Part B Pricing
- Not separately priced by Part B (indicator 00)
- Type of Service
- Medical care
- Effective Date
- 2024-01-01
- 2026 Maintenance
- No change this year
References
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Reference G9998 with the canonical source and edition:
G9998 — Documentation 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]). ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/G9998
Canonical URL: https://icd10codingpro.com/hcpcs-codes/G9998