Medicare Coverage & Payment

CMS short descriptor: Pt inelig; lo to no dter rsk
Medicare coverage: Carrier judgment (CMS coverage code C)
Payment category: Service not separately priced (pricing indicator 00)
BETOS: M5D — Specialist - other
Last CMS action effective: January 1, 2015
Terminated: December 31, 2014

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Code Set: Removed from the code set — not valid on or after January 1, 2015.

Contextual Map

Every relationship of G8464 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes (40)

G8416 — Clinician documented that patient was not an eligible candidate for footwear evaluation measure[Sibling]— CMS HCPCS Level II code set
G8417 — Bmi is documented above normal parameters and a follow-up plan is documented[Sibling]— CMS HCPCS Level II code set
G8418 — Bmi is documented below normal parameters and a follow-up plan is documented[Sibling]— CMS HCPCS Level II code set
G8419 — Bmi documented outside normal parameters, no follow-up plan documented, no reason given[Sibling]— CMS HCPCS Level II code set
G8420 — Bmi is documented within normal parameters and no follow-up plan is required[Sibling]— CMS HCPCS Level II code set
G8421 — Bmi not documented and no reason is given[Sibling]— CMS HCPCS Level II code set
G8422 — Bmi not documented, documentation the patient is not eligible for bmi calculation[Sibling]— CMS HCPCS Level II code set
G8427 — Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications[Sibling]— CMS HCPCS Level II code set
and 32 more

Change history (2)

January 1, 2015 — Removed from the code set [Change history]— CMS release files (code change ledger)
and 1 more

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, descriptors, coverage and pricing attributes Official source data: CMS HCPCS Alpha-Numeric (ANWEB) release — July 2026 quarterly update Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data: CMS HCPCS quarterly update files, ingested into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship: Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation: Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

January 1, 2015
Removed from the code set
Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined
January 1, 2008
Added to the code set
Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined

Nearest Codes in This Family

Official HCPCS Level II classifications closest to G8464 in its code family, with their registry titles.

G8464 HCPCS Level II Code: Clinician documented that prostate cancer patient is not an eligible candidate for adjuvant hormonal therapy; low or intermediate risk of recurrence or risk of recurrence not determined