G9247 HCPCS Level II Code: Patient had two eligible encounters at least 90 days apart or one eligible encounter and one HIV viral load test at least 90 days apart
Medicare Coverage & Payment
- CMS short descriptor: 2 enc enc/vir ld 90d
- 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, 2025
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 G9247 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)
- G9227 — Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter[Sibling]— CMS HCPCS Level II code set
- G9228 — Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)[Sibling]— CMS HCPCS Level II code set
- G9229 — Chlamydia, gonorrhea, and syphilis screening results not documented (patient refusal is the only allowed exception)[Sibling]— CMS HCPCS Level II code set
- G9230 — Chlamydia, gonorrhea, and syphilis not screened, reason not given[Sibling]— CMS HCPCS Level II code set
- G9231 — Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period[Sibling]— CMS HCPCS Level II code set
- 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 comorbid condition; the patient is unwilling to communicate the diagnosis of a comorbid condition; or the patient is unaware of the comorbid condition, or any other specified patient reason)[Sibling]— CMS HCPCS Level II code set
- G9233 — All quality actions for the applicable measures in the total knee replacement measures group have been performed for this patient[Sibling]— CMS HCPCS Level II code set
- G9234 — I intend to report the total knee replacement measures group[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 setPatient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G9247 in its code family, with their registry titles.
- G9242 — Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed
- G9243 — Documentation of viral load less than 200 copies/ml
- G9244 — Antiretroviral thereapy not prescribed
- G9245 — Antiretroviral therapy prescribed
- G9246 — Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart
- G9248 — Patient did not have a medical visit in the last 6 months
- G9249 — Patient had a medical visit in the last 6 months
- G9250 — Documentation of patient pain brought to a comfortable level within 48 hours from initial assessment
- G9251 — Documentation of patient with pain not brought to a comfortable level within 48 hours from initial assessment
- G9252 — Adenoma(s) or other neoplasm detected during screening colonoscopy