G8430 HCPCS code: Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status)
G8430 is the HCPCS Level II code for documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status). 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 | 2008-01-01 |
| Last action effective | 2026-01-01 |
What changed for G8430
- January 2026: Descriptor revised (Was: Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an urgent or emergent medical situation))
- 2008-01-01: G8430 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 G8430?
G8430 is the HCPCS Level II code for documentation of a medical reason(s) for not documenting, updating, or reviewing the patient's current medications list (e.g., patient is in an acute health crisis where time is of the essence and delay of treatment would jeopardize the patient's health status). Short descriptor: "Doc med rsn no medrec".
Does Medicare cover G8430?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G84 codes
- G8400 — Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given
- G8401 — Clinician documented that patient was not an eligible candidate for screening
- G8404 — Lower extremity neurological exam performed and documented
- G8405 — Lower extremity neurological exam not performed
- G8406 — Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure
- G8410 — Footwear evaluation performed and documented
- G8415 — Footwear evaluation was not performed
- G8416 — Clinician documented that patient was not an eligible candidate for footwear evaluation measure
- G8417 — Bmi is documented above normal parameters and a follow-up plan is documented
- G8418 — Bmi is documented below normal parameters and a follow-up plan is documented
- G8419 — Bmi documented outside normal parameters, no follow-up plan documented, no reason given
- G8420 — Bmi is documented within normal parameters and no follow-up plan is required
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Next steps
- Run a reimbursement report for a device billed under G8430
- Watch G8430 for fee, coverage and descriptor changes
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Sources: CMS HCPCS Level II release October 2026; 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.