G9638 HCPCS code: Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique)
G9638 is the HCPCS Level II code for final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique). 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 | 2016-01-01 |
| Last action effective | 2016-01-01 |
What changed for G9638
- 2016-01-01: G9638 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 G9638?
G9638 is the HCPCS Level II code for final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique). Short descriptor: "No doc >1 dose reduc tech".
Does Medicare cover G9638?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G96 codes
- G9600 — Symptomatic aaas that required urgent/emergent (non-elective) repair
- G9601 — Patient discharge to home no later than post-operative day #7
- G9602 — Patient not discharged to home by post-operative day #7
- G9603 — Patient survey score improved from baseline following treatment
- G9604 — Patient survey results not available
- G9605 — Patient survey score did not improve from baseline following treatment
- G9606 — Intraoperative cystoscopy performed to evaluate for lower tract injury
- G9607 — Documented medical reasons for not performing intraoperative cystoscopy (e.g., urethral pathology precluding cystoscopy, any patient who has a congenital or acquired absence of the urethra) or in the case of patient death
- G9608 — Intraoperative cystoscopy not performed to evaluate for lower tract injury
- G9609 — Documentation of an order for anti-platelet agents
- G9610 — Documentation of medical reason(s) in the patient's record for not ordering anti-platelet agents
- G9611 — Order for anti-platelet agents was not documented in the patient's record, reason not given
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Next steps
- Run a reimbursement report for a device billed under G9638
- Watch G9638 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9638
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.