2025 HCPCS Code G2116

Patients 66 - 80 years of age with at least one claim/encounter for frailty during the measurement period and either one acute inpatient encounter with a diagnosis of advanced illness or two outpatient, observation, ed or nonacute inpatient encounters on different dates of service with an advanced illness diagnosis during the measurement period or the year prior to the measurement period

TAGS: illness patients prior advanced frailty inpatient encounter acute period nonacute encounters years dates service diagnosis different during measurement either least

Short Description	Pt 66-80 frailty and adv ill
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	C - Carrier judgment
HCPCS Code Added Date	January 01, 2020
HCPCS Action Effective Date	January 01, 2021
HCPCS Pricing Indicator Code	00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Type Of Service Code	1 - Medical care
HCPCS Multiple Pricing Indicator Code	9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Coverage Issues Manual Reference Section Number

Check Similar HCPCS Codes

• G9110 - Onc dx head/neck t3-4 noprog
• G9111 - Onc dx head/neck m1 mets rec
• G9112 - Onc dx head/neck ext unknown
• G9113 - Onc dx ovarian stg1a-b no pr
• G9114 - Onc dx ovarian stg1a-b or 2
• G9115 - Onc dx ovarian stg3/4 noprog
• G9116 - Onc dx ovarian recurrence
• G9117 - Onc dx ovarian unknown nos
• G9123 - Onc dx cml chronic phase
• G9124 - Onc dx cml acceler phase
• G9125 - Onc dx cml blast phase
• G9126 - Onc dx cml remission
• G9128 - Onc dx multi myeloma stage i
• G9129 - Onc dx mult myeloma stg2 hig
• G9130 - Onc dx multi myeloma unknown
• G9131 - Onc dx brst unknown nos
• G9132 - Onc dx prostate mets no cast
• G9133 - Onc dx prostate clinical met
• G9134 - Onc nhlstg 1-2 no relap no
• G9135 - Onc dx nhl stg 3-4 not relap