G9659 HCPCS code: Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits
G9659 is the HCPCS Level II code for patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits. 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 | 2025-01-01 |
What changed for G9659
- 2016-01-01: G9659 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 G9659?
G9659 is the HCPCS Level II code for patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, familial adenomatous polyposis, lynch syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease (i.e., crohn's disease or ulcerative colitis), abnormal finding of gastrointestinal tract, weight loss, or changes in bowel habits. Short descriptor: ">=86y scr colo nomed rsn".
Does Medicare cover G9659?
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 G9659
- Watch G9659 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9659
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.