G0921 HCPCS code: Documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment)
G0921 is the HCPCS Level II code for documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment). CMS terminated G0921 on 2014-12-31; do not bill it for later dates of service. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | G codes — Procedures and professional services (temporary) |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | M5D |
| Added | 2012-01-01 |
| Last action effective | 2015-01-01 |
| Terminated | 2014-12-31 |
What changed for G0921
- 2012-01-01: G0921 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code G0921?
G0921 is the HCPCS Level II code for documentation of patient reason(s) for not being able to assess (e.g., patient refuses endoscopic and/or radiologic assessment). Short descriptor: "Doc pt reas no assess".
Does Medicare cover G0921?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G09 codes
- G0908 — Most recent hemoglobin (hgb) level > 12.0 g/dl
- G0909 — Hemoglobin level measurement not documented, reason not given
- G0910 — Most recent hemoglobin level <= 12.0 g/dl
- G0913 — Improvement in visual function achieved within 90 days following cataract surgery
- G0914 — Patient care survey was not completed by patient
- G0915 — Improvement in visual function not achieved within 90 days following cataract surgery
- G0916 — Satisfaction with care achieved within 90 days following cataract surgery
- G0917 — Patient care survey was not completed by patient
- G0918 — Satisfaction with care not achieved within 90 days following cataract surgery
- G0919 — Influenza immunization ordered or recommended (to be given at alternate location or alternate provider); vaccine not available at time of visit
- G0920 — Type, anatomic location, and activity all documented
- G0922 — No documentation of disease type, anatomic location, and activity, reason not given
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Next steps
- Run a reimbursement report for a device billed under G0921
- Watch G0921 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0921
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.