G9924 HCPCS – Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

HCPCS G9924: Documentation of Medical Reason to Omit Safety Screening

HCPCS Level II code G9924 is used to document a medical justification for not performing a safety concerns screen or for not providing recommendations, orders, or referrals after a positive screen (for example, when a patient is in palliative care). The code is important nationally because it standardizes reporting when clinicians reasonably omit screening actions for clinical reasons, supporting consistent claims documentation and facilitating administrative review.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise coverage of the code's clinical intent, typical sites of service, and the types of documentation expected. The publication summarizes payer applicability and common modifiers reported with this code, outlines typical clinical contexts in which G9924 is used, and highlights documentation elements that support appropriate use.

This summary provides a national perspective useful for billing, compliance, and clinical documentation teams seeking to understand when G9924 applies, what it represents in patient care, and how major payers treat instances where safety screening or follow-up is omitted for medical reasons. Data not available in the input is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9924HCPCS Level IIsafety screeningclinical documentationambulatory carepalliative carebilling compliancemedical justification

Billing Code Overview

HCPCS Level II code G9924 documents the medical reason(s) for not providing a safety concerns screen or for not providing recommendations, orders, or referrals for a positive screen (for example, when a patient is in palliative care or has another medical reason). This code captures clinician documentation that a standard safety-screening intervention was medically inappropriate or contraindicated.

Service type: Clinical documentation of justification for omission of a safety concerns screen or follow-up actions
Typical site of service: Outpatient clinical settings where screening would normally occur, including primary care, specialty clinics, or other ambulatory care environments

Clinical & Coding Specifications

Clinical Context

A primary care clinician or behavioral health clinician in an office or outpatient clinic documents that a standardized safety concerns screen (e.g., screening for suicidal ideation, homicidal ideation, or other immediate safety risks) was not completed or that follow-up recommendations/orders/referrals for a positive screen were not provided because of documented medical reasons. A realistic scenario: an 82-year-old male with advanced metastatic pancreatic cancer under hospice/palliative management presents for routine symptom check. The clinician documents that a formal safety concerns screen was not performed due to the patient’s limited life expectancy and focus on comfort-directed care, and documents medical rationale (palliative goals, severe cognitive impairment, unstable medical condition) preventing standard screening or referral. Typical workflow: clinician reviews chart, discusses goals of care with patient/family, determines screening not clinically appropriate, documents the medical reason(s) and signs the note. Billing staff submits G9924 to indicate documentation of medical reason(s) for not providing the safety concerns screen or not providing recommendations/orders/referrals after a positive screen.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or resources required are substantially greater than typically required.

Related Codes

HCPCS-G9741-HOSPICE-UTILIZATION-MEASURE

HCPCS G9741: Hospice Service Utilization Measure

HCPCS-G9838-METASTATIC-DISEASE-AT-DIAGNOSIS

HCPCS G9838: Patient Has Metastatic Disease at Diagnosis

HCPCS-G9813-POST-PROCEDURE-30-DAY-SURVIVAL

HCPCS G9813: Patient Did Not Die Within 30 Days of Procedure or During Index Hospitalization

HCPCS-G8595-MOST-RECENT-LDL-C-UNDER-100-MGDL

HCPCS G8595: Most Recent LDL-C < 100 mg/dl

HCPCS-G9761-HOSPICE-UTILIZATION-MEASUREMENT-PERIOD

HCPCS G9761: Patients Using Hospice Services During Measurement Period

HCPCS-G9796-HIGH-INTENSITY-STATIN-THERAPY

HCPCS G9796: High-Intensity Statin Therapy

HCPCS-G9482-REMOTE-IN-HOME-EVALUATION-NEW-PATIENT-TELEMEDICINE

HCPCS G9482: Remote In-Home Evaluation and Management for New Patient

HCPCS-G0920-TYPE-ANATOMIC-LOCATION-ACTIVITY-DOCUMENTED

HCPCS G0920: Type, Anatomic Location, and Activity Documented

HCPCS-G0661-TEAM-REMOTE-EM-NEW-PATIENT-20MIN

HCPCS G0661: Team Remote E/M for New Patient, 20 Minutes

HCPCS-G9842-METASTATIC-DISEASE-AT-DIAGNOSIS

HCPCS G9842: Metastatic Disease at Diagnosis

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Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care clinicians often document rationale for omitting routine safety screens.
`208D00000X`	Neurology	Neurologists may document omissions when cognitive impairment prevents valid screening.
`207P00000X`	Internal Medicine	Hospitalists and outpatient internists document medical justifications for not performing screening.
`251B00000X`	Palliative Medicine	Palliative care clinicians frequently document goal-concordant omissions of screening and referrals.
`2084P0800X`	Psychiatry	Psychiatrists document reasons when standard safety screening/referral is deferred for medical reasons.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z51.5`	Encounter for palliative care	Patients receiving palliative care commonly have documented medical reasons to omit safety concern screening or to forgo referrals.
`Z74.3`	Need for continuous supervision	Severe disability or need for supervision can limit ability to complete standardized screens, justifying `G9924`.
`F03.90`	Mild cognitive impairment, unspecified	Cognitive impairment may render screening invalid or distressing; clinicians document rationale for omission.
`C25.9`	Malignant neoplasm of pancreas, unspecified	Advanced incurable illness often leads to goal-concordant omission of routine safety screens.
`R41.82`	Altered mental status, unspecified	Acute delirium or altered mental status can prevent completion of safety screening and necessitate documented reason.
`Z66`	Do not resuscitate/advanced directive status	Documented goals limiting interventions can support omission of standard safety screening or referrals.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M visit during which clinician documents medical reason(s) for omitting safety screening; billing for the visit while using `G9924` to indicate documentation of omission.
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, typically 25 minutes	Used for more complex visits where clinician documents detailed rationale for not performing screening or not providing follow-up recommendations/referrals.
`99406`	Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutes	Example of a behavioral intervention code that might be considered when screening is performed; absence may be documented with `G9924` when not provided for medical reasons.
`99407`	Smoking and tobacco use cessation counseling, intensive, greater than 10 minutes	Higher-intensity counseling that may be omitted for medical reasons and documented using `G9924`.
`96127`	Brief emotional/behavioral assessment (e.g., depression inventory)	Screening instrument code often used when safety or behavioral screening is performed; `G9924` documents when such screening is not completed due to medical reasons.
`99499`	Unspecified evaluation and management service	Rarely used for atypical or unlisted services in behavioral health workflows; may be part of a visit where omission is documented using `G9924`.