G8398 — Dilated macular or fundus exam not performed
G8398 is a HCPCS Level II code for dilated macular or fundus exam not performed. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2020 and is not valid on new claims.
This code has been terminated
CMS terminated G8398 on December 31, 2020. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
The CMS record for G8398
- Long descriptor
- Dilated macular or fundus exam not performed
- Short descriptor
- Dil macular/fundus not perfo
- Added
- January 1, 2008
- Terminated
- December 31, 2020
- BETOS
- M5D
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8398
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8398 is not quite right, the correct code is very often within a few positions of it.
- G6057Phenothiazineterminated
- G6058Drug confirmation, each procedureterminated
- G8126Patient with a diagnosis of major depression documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phaseterminated
- G8127Patient with a diagnosis of major depression not documented as being treated with antidepressant medication during the entire 84 day (12 week) acute treatment phaseterminated
- G8128Clinician documented that patient was not an eligible candidate for antidepressant medication during the entire 12 week acute treatment phase measureterminated
- G8395Left ventricular ejection fraction (lvef) >= 40% or documentation as normal or mildly depressed left ventricular systolic function
- G8396Left ventricular ejection fraction (lvef) not performed or documented
- G8397Dilated macular or fundus exam performed, including documentation of the presence or absence of macular edema and level of severity of retinopathy
- G8399Patient with documented results of a central dual-energy x-ray absorptiometry (dxa) ever being performed
- G8400Patient with central dual-energy x-ray absorptiometry (dxa) results not documented, reason not given
- G8401Clinician documented that patient was not an eligible candidate for screeningterminated
- G8404Lower extremity neurological exam performed and documented
- G8405Lower extremity neurological exam not performed
- G8406Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measureterminated
- G8410Footwear evaluation performed and documented
- G8415Footwear evaluation was not performed
Questions about G8398
What is HCPCS code G8398?
G8398 is a HCPCS Level II code for dilated macular or fundus exam not performed. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8398?
The CMS HCPCS file marks G8398 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
Is G8398 still valid?
No. G8398 was terminated on December 31, 2020 and should not be used on new claims.