G9403 HCPCS code: Clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up)
G9403 is the HCPCS Level II code for clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up). CMS terminated G9403 on 2024-12-31; 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 | Z2 |
| Added | 2015-01-01 |
| Last action effective | 2025-01-01 |
| Terminated | 2024-12-31 |
What changed for G9403
- 2015-01-01: G9403 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 G9403?
G9403 is the HCPCS Level II code for clinician documented reason patient was not able to complete 30 day follow-up from acute inpatient setting discharge (e.g., patient death prior to follow-up visit, patient non-compliant for visit follow-up). Short descriptor: "Doc reas no 30 day f/u".
Does Medicare cover G9403?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G94 codes
- G9400 — Documentation of medical or patient reason(s) for not discussing treatment options; medical reasons: patient is not a candidate for treatment due to advanced physical or mental health comorbidity (including active substance use); currently receiving antiviral treatment; successful antiviral treatment (with sustained virologic response) prior to reporting period; other documented medical reasons; patient reasons: patient unable or unwilling to participate in the discussion or other patient reasons
- G9401 — No documentation in the patient record of a discussion between the physician or other qualified healthcare professional and the patient that includes all of the following: treatment choices appropriate to genotype, risks and benefits, evidence of effectiveness, and patient preferences toward treatment
- G9402 — Patient received follow-up within 30 days after discharge
- G9404 — Patient did not receive follow-up within 30 days after discharge
- G9405 — Patient received follow-up within 7 days after discharge
- G9406 — Clinician documented reason patient was not able to complete 7 day follow-up from acute inpatient setting discharge (i.e patient death prior to follow-up visit, patient non-compliance for visit follow-up)
- G9407 — Patient did not receive follow-up within 7 days after discharge
- G9408 — Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
- G9409 — Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days
- G9410 — Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
- G9411 — Patient not admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
- G9412 — Patient admitted within 180 days, status post cied implantation, replacement, or revision with an infection requiring device removal or surgical revision
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Next steps
- Run a reimbursement report for a device billed under G9403
- Watch G9403 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9403
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.