G9701 HCPCS code: Children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established
G9701 is the HCPCS Level II code for children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established. CMS terminated G9701 on 2020-12-31; 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 | 2017-01-01 |
| Last action effective | 2021-01-01 |
| Terminated | 2020-12-31 |
What changed for G9701
- 2017-01-01: G9701 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 G9701?
G9701 is the HCPCS Level II code for children who are taking antibiotics in the 30 days prior to the date of the encounter during which the diagnosis was established. Short descriptor: "Child anbx 30 prior dx estab".
Does Medicare cover G9701?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related G97 codes
- G9700 — Patients who use hospice services any time during the measurement period
- G9702 — Patients who use hospice services any time during the measurement period
- G9703 — Episodes where the patient is taking antibiotics (table 1) in the 30 days prior to the episode date
- G9704 — Ajcc breast cancer stage i: t1 mic or t1a documented
- G9705 — Ajcc breast cancer stage i: t1b (tumor > 0.5 cm but <= 1 cm in greatest dimension) documented
- G9706 — Low (or very low) risk of recurrence, prostate cancer
- G9707 — Patient received hospice services any time during the measurement period
- G9708 — Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy
- G9709 — Hospice services used by patient any time during the measurement period
- G9710 — Patient was provided hospice services any time during the measurement period
- G9711 — Patients with a diagnosis or past history of total colectomy or colorectal cancer
- G9712 — Documentation of medical reason(s) for prescribing or dispensing antibiotic (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/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/uti, acne, hiv disease/asymptomatic hiv, cystic fibrosis, disorders of the immune system, malignancy neoplasms, chronic bronchitis, emphysema, bronchiectasis, extrinsic allergic alveolitis, chronic airway obstruction, chronic obstructive asthma, pneumoconiosis and other lung disease due to external agents, other diseases of the respiratory system, and tuberculosis
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Next steps
- Run a reimbursement report for a device billed under G9701
- Watch G9701 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G9701
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.