G9227 HCPCS Level II Code: Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter
Medicare Coverage & Payment
- CMS short descriptor: Foa doc, care plan not doc
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Payment category: Service not separately priced (pricing indicator 00)
- BETOS: M5B — Specialist - psychiatry
- Last CMS action effective: January 1, 2018
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.
Contextual Map
Every relationship of G9227 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)
- G9207 — Hepatitis c genotype testing documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c[Sibling]— CMS HCPCS Level II code set
- G9208 — Hepatitis c genotype testing was not documented as performed within 12 months prior to initiation of antiviral treatment for hepatitis c, reason not given[Sibling]— CMS HCPCS Level II code set
- G9209 — Hepatitis c quantitative rna testing documented as performed between 4-12 weeks after the initiation of antiviral treatment[Sibling]— CMS HCPCS Level II code set
- G9210 — Hepatitis c quantitative rna testing not performed between 4-12 weeks after the initiation of antiviral treatment for documented reason(s) (e.g., patients whose treatment was discontinued during the testing period prior to testing, other medical reasons, patient declined, other patient reasons)[Sibling]— CMS HCPCS Level II code set
- G9211 — Hepatitis c quantitative rna testing was not documented as performed between 4-12 weeks after the initiation of antiviral treatment, reason not given[Sibling]— CMS HCPCS Level II code set
- G9212 — Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation[Sibling]— CMS HCPCS Level II code set
- G9213 — Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified[Sibling]— CMS HCPCS Level II code set
- G9214 — Cd4+ cell count or cd4+ cell percentage results documented[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history
- January 1, 2014 — Added to the code set [Change history]— CMS release files (code change ledger)
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, 2014Added to the code setFunctional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G9227 in its code family, with their registry titles.
- G9222 — Pneumocystis jiroveci pneumonia prophylaxis prescribed wthin 3 months of low cd4+ cell count below 200 cells/mm3
- G9223 — Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%
- G9224 — Documentation of medical reason for not performing foot exam (e.g., patient with bilateral foot/leg amputation)
- G9225 — Foot exam was not performed, reason not given
- G9226 — Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick…
- G9228 — Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)
- G9229 — Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)
- G9230 — Chlamydia, gonorrhea, and syphilis not screened, reason not given
- G9231 — Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period
- G9232 — Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition for specified patient reason (e.g., patient is unable to communicate the diagnosis of a…