G9286 — Antibiotic regimen prescribed within 10 days after onset of symptoms
G9286 is a HCPCS Level II code for antibiotic regimen prescribed within 10 days after onset of symptoms. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.
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.
Physician fee schedule statusM
Measurement code. Used for reporting purposes only; never paid.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for G9286
- Long descriptor
- Antibiotic regimen prescribed within 10 days after onset of symptoms
- Short descriptor
- Antibio rx w in 10d of sympt
- Added
- January 1, 2014
- 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.
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 G9286
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9286 is not quite right, the correct code is very often within a few positions of it.
- G9278Documentation that the patient is not on daily aspirin or anti-platelet regimen
- G9279Pneumococcal screening performed and documentation of vaccination received prior to discharge
- G9280Pneumococcal vaccination not administered prior to discharge, reason not specified
- G9281Screening performed and documentation that vaccination not indicated/patient refusal
- G9282Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of non-small cell lung cancer or other documented medical reasons)
- G9283Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
- G9284Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
- G9285Specimen site other than anatomic location of lung or is not classified as non small cell lung cancer
- G9287Antibiotic regimen not prescribed within 10 days after onset of symptoms
- G9288Documentation of medical reason(s) for not reporting the histological type or nsclc-nos classification with an explanation (e.g., a solitary fibrous tumor in a person with a history of non-small cell carcinoma or other documented medical reasons)
- G9289Non small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type or classified as nsclc-nos with an explanation
- G9290Non small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type or classified as nsclc-nos with an explanation
- G9291Specimen site other than anatomic location of lung, is not classified as non small cell lung cancer or classified as nsclc-nos
- G9292Documentation of medical reason(s) for not reporting pt category and a statement on thickness and ulceration and for pt1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)
- G9293Pathology report does not include the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
- G9294Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
Questions about G9286
What is HCPCS code G9286?
G9286 is a HCPCS Level II code for antibiotic regimen prescribed within 10 days after onset of symptoms. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9286?
The CMS HCPCS file marks G9286 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.
How is G9286 paid under the physician fee schedule?
G9286 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.