G9536 HCPCS Level II code: Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the…
CMS terminated G9536: its last date of service was Dec 31, 2018. It stays here for looking up older claims; newer services need a current code.
Official description
G9536Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
Short description: Doc med reas adv brain image
HCPCS · United States
Medicare details
The indicators CMS publishes with G9536 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Undefined codes
- Added
- Jan 1, 2016
- Terminated after
- Dec 31, 2018
Where G9536 sits
- 1G codesProcedures and professional services
- 2Terminated G9536Documentation of medical reason(s) for ordering an advanced brain imaging study (i.e., patient has an abnormal neurological examination; patient has the coexistence of seizures, or both; recent onset of severe headache; change in the type of headache; signs of increased intracranial pressure (e.g., papilledema, absent venous pulsations on funduscopic examination, altered mental status, focal neurologic deficits, signs of meningeal irritation); hiv-positive patients with a new type of headache; immunocompromised patient with unexplained headache symptoms; patient on coagulopathy/anti-coagulation or anti-platelet therapy; very young patients with unexplained headache symptoms)
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
Is HCPCS code G9536 still valid?
No. CMS terminated G9536; its last date of service was Dec 31, 2018. It is listed for looking up services from before then. Use a current code for newer services.
Does Medicare cover G9536?
CMS lists G9536’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G9536
All G codesG9530Patient presented with a minor blunt head trauma and had a head ct ordered for trauma by an emergency care providerG9531Patient has documentation of ventricular shunt, brain tumor, multisystem trauma, or is currently taking an antiplatelet medication including: abciximab, anagrelide, cangrelor…G9532Patient had a head ct for trauma ordered by someone other than an emergency care provider or was ordered for a reason other than traumaG9533Patient with minor blunt head trauma did not have an appropriate indication(s) for a head ctG9534Advanced brain imaging (cta, ct, mra or mri) was not orderedG9535Patients with a normal neurological examinationG9537Imaging needed as part of a clinical trial; or other clinician ordered the studyG9538Advanced brain imaging (cta, ct, mra or mri) was orderedG9539Intent for potential removal at time of placementG9540Patient alive 3 months post procedureG9541Filter removed within 3 months of placementG9542Documented re-assessment for the appropriateness of filter removal within 3 months of placement