G8726 — Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
G8726 is a HCPCS Level II code for clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons). It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2016 and is not valid on new claims.
This code has been terminated
CMS terminated G8726 on December 31, 2016. 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 G8726
- Long descriptor
- Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)
- Short descriptor
- Doc reas no lipid profile
- Added
- January 1, 2012
- Terminated
- December 31, 2016
- BETOS
- M5B
- 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 G8726
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8726 is not quite right, the correct code is very often within a few positions of it.
- G8717Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not giventerminated
- G8718Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])terminated
- G8720Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])terminated
- G8721Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report
- G8722Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)
- G8723Specimen site is other than anatomic location of primary tumor
- G8724Pt category, pn category and histologic grade were not documented in the pathology report, reason not given
- G8725Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)terminated
- G8728Fasting lipid profile not performed, reason not giventerminated
- G8730Pain assessment documented as positive using a standardized tool and a follow-up plan is documentedterminated
- G8731Pain assessment using a standardized tool is documented as negative, no follow-up plan requiredterminated
- G8732No documentation of pain assessment, reason not giventerminated
- G8733Elder maltreatment screen documented as positive and a follow-up plan is documented
- G8734Elder maltreatment screen documented as negative, follow-up is not required
- G8735Elder maltreatment screen documented as positive, follow-up plan not documented, reason not given
- G8736Most current ldl-c <100mg/dlterminated
Questions about G8726
What is HCPCS code G8726?
G8726 is a HCPCS Level II code for clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons). It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8726?
The CMS HCPCS file marks G8726 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 G8726 still valid?
No. G8726 was terminated on December 31, 2016 and should not be used on new claims.