G9223 Pneumocystis jiroveci pneumonia prophylaxis prescribed within 3 months of low cd4+ cell count below 500 cells/mm3 or a cd4 percentage below 15%

Billable / valid for submission HCPCS Release 2026Q3

Short description: Pjp proph ordered cd4 low

Version history

Related codes in G92

• G9212 Dsm-ivtm criteria for major depressive disorder documented at the initial evaluation
• G9213 Dsm-iv-tr criteria for major depressive disorder not documented at the initial evaluation, reason not otherwise specified
• G9225 Foot exam was not performed, reason not given
• G9226 Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed)
• G9227 Functional outcome assessment documented, care plan not documented, documentation the patient is not eligible for a care plan at the time of the encounter
• G9228 Chlamydia, gonorrhea and syphilis screening results documented (report when results are present for all of the 3 screenings)
• G9230 Chlamydia, gonorrhea, and syphilis not screened, reason not given
• G9231 Documentation of end stage renal disease (esrd), dialysis, renal transplant before or during the measurement period or pregnancy during the measurement period
• G9242 Documentation of viral load equal to or greater than 200 copies/ml or viral load not performed
• G9243 Documentation of viral load less than 200 copies/ml
• G9246 Patient did not have two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart
• G9247 Patient had two eligible encounters at least 90 days apart or one eligible encounter and one hiv viral load test at least 90 days apart
• G9254 Documentation of patient discharged to home later than post-operative day 2 following cea or cas
• G9255 Documentation of patient discharged to home no later than post operative day 2 following cea or cas
• G9273 Blood pressure has a systolic value of < 140 and a diastolic value of < 90
• G9274 Blood pressure has a systolic value of =140 and a diastolic value of = 90 or systolic value < 140 and diastolic value = 90 or systolic value = 140 and diastolic value < 90
• G9275 Documentation that patient is a current non-tobacco user
• G9276 Documentation that patient is a current tobacco user
• G9277 Documentation that the patient is on daily aspirin or anti-platelet or has documentation of a valid contraindication or exception to aspirin/anti-platelet; contraindications/exceptions include anti-coagulant use, allergy to aspirin or anti-platelets, history of gastrointestinal bleed and bleeding disorder; additionally, the following exceptions documented by the physician as a reason for not taking daily aspirin or anti-platelet are acceptable (use of non-steroidal anti-inflammatory agents, documented risk for drug interaction, uncontrolled hypertension defined as >180 systolic or >110 diastolic or gastroesophageal reflux)
• G9278 Documentation that the patient is not on daily aspirin or anti-platelet regimen

All G92 codes →