G9294 — Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
G9294 is a HCPCS Level II code for pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate. 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 G9294
- Long descriptor
- Pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate
- Short descriptor
- Pt cat and thck on report
- 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 G9294
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G9294 is not quite right, the correct code is very often within a few positions of it.
- G9286Antibiotic regimen prescribed within 10 days after onset of symptoms
- 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
- G9295Specimen site other than anatomic cutaneous location
- G9296Patients with documented shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure
- G9297Shared decision-making including discussion of conservative (non-surgical) therapy (e.g., nsaids, analgesics, weight loss, exercise, injections) prior to the procedure, not documented, reason not given
- G9298Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke)
- G9299Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of dvt, pe, mi, arrhythmia and stroke, reason not given)
- G9300Documentation of medical reason(s) for not completely infusing the prophylactic antibiotic prior to the inflation of the proximal tourniquet (e.g., a tourniquet was not used)terminated
- G9301Patients who had the prophylactic antibiotic completely infused prior to the inflation of the proximal tourniquetterminated
- G9302Prophylactic antibiotic not completely infused prior to the inflation of the proximal tourniquet, reason not giventerminated
Questions about G9294
What is HCPCS code G9294?
G9294 is a HCPCS Level II code for pathology report includes the pt category and a statement on thickness and ulceration and for pt1, mitotic rate. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G9294?
The CMS HCPCS file marks G9294 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 G9294 paid under the physician fee schedule?
G9294 carries PFS status code M. Measurement code. Used for reporting purposes only; never paid.