G8539 Functional outcome assessment documented as positive using a standardized tool and a care plan based on identified deficiencies is documented within two days of the functional outcome assessment

Billable / valid for submission HCPCS Release 2026Q3

Short description: Doc funct and care plan

Version history

Related codes in G85

• G8510 Screening for depression is documented as negative, a follow-up plan is not required
• G8511 Screening for depression documented as positive, follow-up plan not documented, reason not given
• G8535 Elder maltreatment screen not documented; documentation that patient is not eligible for the elder maltreatment screen at the time of the encounter related to one of the following reasons: (1) patient refuses to participate in the screening and has reasonable decisional capacity for self-protection, or (2) patient is in an urgent or emergent situation where time is of the essence and to delay treatment to perform the screening would jeopardize the patient's health status
• G8536 No documentation of an elder maltreatment screen, reason not given
• G8540 Functional outcome assessment not documented as being performed, documentation the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter
• G8541 Functional outcome assessment using a standardized tool not documented, reason not given
• G8542 Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required
• G8543 Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
• G8559 Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
• G8560 Patient has a history of active drainage from the ear within the previous 90 days
• G8561 Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
• G8562 Patient does not have a history of active drainage from the ear within the previous 90 days
• G8563 Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
• G8564 Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)
• G8565 Verification and documentation of sudden or rapidly progressive hearing loss
• G8566 Patient is not eligible for the "referral for otologic evaluation for sudden or rapidly progressive hearing loss" measure
• G8567 Patient does not have verification and documentation of sudden or rapidly progressive hearing loss
• G8568 Patient was not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
• G8569 Prolonged postoperative intubation (> 24 hrs) required
• G8570 Prolonged postoperative intubation (> 24 hrs) not required

All G85 codes →