G8709 HCPCS code: Uri episodes when the patient had competing diagnoses on or three days after the episode date (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, or 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 or uti, and acne)
G8709 is the HCPCS Level II code for uri episodes when the patient had competing diagnoses on or three days after the episode date (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, or 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 or uti, and acne). 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 | M5B |
| Added | 2012-01-01 |
| Last action effective | 2021-01-01 |
What changed for G8709
- 2012-01-01: G8709 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 G8709?
G8709 is the HCPCS Level II code for uri episodes when the patient had competing diagnoses on or three days after the episode date (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, or 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 or uti, and acne). Short descriptor: "Uri ep compete diag".
Does Medicare cover G8709?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G87 codes
- G8700 — Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge
- G8701 — Rehabilitation services were not ordered, reason not otherwise specified
- G8702 — Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively
- G8703 — Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively
- G8704 — 12-lead electrocardiogram (ECG) performed
- G8705 — Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ECG)
- G8706 — Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ECG)
- G8707 — 12-lead electrocardiogram (ECG) not performed, reason not given
- G8708 — Patient not prescribed antibiotic
- G8710 — Patient prescribed antibiotic
- G8711 — Prescribed antibiotic on or within 3 days after the episode date
- G8712 — Antibiotic not prescribed or dispensed
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Next steps
- Run a reimbursement report for a device billed under G8709
- Watch G8709 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G8709
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.