HCPCS Level II · Procedures and professional services (temporary)
G9513Individual did not have a pdc of 0.8 or greater
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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About G9513
G9513 is an HCPCS Level II code in the G series (procedures and professional services (temporary)), describing individual did not have a pdc of 0.8 or greater.
It was added to HCPCS effective 01/01/2016.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Indiv pdc not > 0.8
- Date added
- 01/01/2016
- Action effective
- 01/01/2016
- BETOS
- Z2
Related G95xx codes
- G9500Radiation exposure indices documented in final report for procedure using fluoroscopy
- G9501Radiation exposure indices not documented in final report for procedure using fluoroscopy, reason not given
- G9502Documentation of medical reason for not performing foot exam (i.e., patients who have had either a bilateral amputation above or below the knee, or both a left and right amputation above or below the knee before or during the measurement period)
- G9504Documented reason for not assessing hepatitis b virus (hbv) status (e.g., patient not initiating anti-tnf therapy, patient declined) prior to initiating anti-tnf therapy
- G9505Antibiotic regimen prescribed within 10 days after onset of symptoms for documented medical reason
- G9507Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)
- G9508Documentation that the patient is not on a statin medication
- G9509Adult patients 18 years of age or older with major depression or dysthymia who reached remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5
- G9510Adult patients 18 years of age or older with major depression or dysthymia who did not reach remission at twelve months as demonstrated by a twelve month (+/-60 days) phq-9 or phq-9m score of less than 5. either phq- 9 or phq-9m score was not assessed or is greater than or equal to 5
- G9511Index event date phq-9 or phq-9m score greater than 9 documented during the twelve month denominator identification period
- G9512Individual had a pdc of 0.8 or greater
- G9514Patient required a return to the operating room within 90 days of surgery
Common questions about G9513
Is HCPCS G9513 still valid?
- Yes. G9513 is active in the CMS October 2026 HCPCS file.
Does Medicare cover G9513?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.