G9836 HCPCS Level II Code: Reason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not…
Medicare Coverage & Payment
- CMS short descriptor: Rsn no trast given doc
- Medicare coverage: Carrier judgment (CMS coverage code C)
- Payment category: Service not separately priced (pricing indicator 00)
- BETOS: Z2 — Undefined codes
- Last CMS action effective: January 1, 2021
- Terminated: December 31, 2020
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, 2021.
Contextual Map
Every relationship of G9836 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)
- G9816 — Death occurring after discharge from the hospital but within 30 days post procedure[Sibling]— CMS HCPCS Level II code set
- G9817 — Death did not occur after discharge from the hospital within 30 days post procedure[Sibling]— CMS HCPCS Level II code set
- G9818 — Documentation of sexual activity[Sibling]— CMS HCPCS Level II code set
- G9819 — Patients who use hospice services any time during the measurement period[Sibling]— CMS HCPCS Level II code set
- G9820 — Documentation of a chlamydia screening test with proper follow-up[Sibling]— CMS HCPCS Level II code set
- G9821 — No documentation of a chlamydia screening test with proper follow-up[Sibling]— CMS HCPCS Level II code set
- G9822 — Patients who had an endometrial ablation procedure during the 12 months prior to the index date (exclusive of the index date)[Sibling]— CMS HCPCS Level II code set
- G9823 — Endometrial sampling or hysteroscopy with biopsy and results documented during the 12 months prior to the index date (exclusive of the index date) of the endometrial ablation[Sibling]— CMS HCPCS Level II code set
- and 32 more
Change history (2)
- January 1, 2021 — 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, 2021Removed from the code setReason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
- January 1, 2017Added to the code setReason for not administering trastuzumab documented (e.g. patient declined, patient died, patient transferred, contraindication or other clinical exclusion, neoadjuvant chemotherapy or radiation not complete)
Nearest Codes in This Family
Official HCPCS Level II classifications closest to G9836 in its code family, with their registry titles.
- G9831 — Ajcc stage at breast cancer diagnosis = ii or iii
- G9832 — Ajcc stage at breast cancer diagnosis = i (ia or ib) and t-stage at breast cancer diagnosis = t1c
- G9833 — Patient transfer to practice after initiation of chemotherapy
- G9834 — Patient has metastatic disease at diagnosis
- G9835 — Trastuzumab administered within 12 months of diagnosis
- G9837 — Trastuzumab not administered within 12 months of diagnosis
- G9838 — Patient has metastatic disease at diagnosis
- G9839 — Anti-egfr monoclonal antibody therapy
- G9840 — Ras (kras and nras) gene mutation testing performed before initiation of anti-egfr moab
- G9841 — Ras (kras and nras) gene mutation testing not performed before initiation of anti-egfr moab