HCPCS G-Codes
Procedures/Professional Services (Temporary Codes)

Temporary G codes are assigned to services and procedures that are under review before being included in the CPT coding system. Payment for these services is under the jurisdiction of the local carriers.

• G8658

  Residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given

• G8659

  Residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)

• G8660

  Residual score for the low back impairment successfully calculated and the score was less than zero (< 0)

• G8661

  Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate

• G8662

  Residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given

• G8663

  Residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)

• G8664

  Residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)

• G8665

  Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate

• G8666

  Residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given

• G8667

  Residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)

• ---

  ---

  Continued

• G8668

  Residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)

• G8669

  Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate

• G8670

  Residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the elbow/wrist/hand fs prom at initial evaluation and/or near discharge, reason not given

• G8671

  Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)

• G8672

  Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)

• G8673

  Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate

• G8674

  Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the general orthopedic fs prom at initial evaluation and/or near discharge, reason not given

• G8682

  Lvf testing documented as being performed prior to discharge or in the previous 12 months

• G8683

  Lvf testing not performed prior to discharge or in the previous 12 months for a medical or patient documented reason

• G8685

  Lvf testing not documented as being performed prior to discharge or in the previous 12 months, reason not given

• G8694

  Current or prior left ventricular ejection fraction (lvef) < = 40% or documentation of moderate or severe lvsd

• G8696

  Antithrombotic therapy prescribed at discharge

• G8697

  Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))

• G8698

  Antithrombotic therapy was not prescribed at discharge, reason not given

• G8699

  Rehabilitation services (occupational, physical or speech) ordered at or prior to discharge

• G8700

  Rehabilitation services (occupational, physical or speech) not indicated at or prior to discharge

• G8701

  Rehabilitation services were not ordered, reason not otherwise specified

• G8702

  Documentation that prophylactic antibiotics were given within 4 hours prior to surgical incision or intraoperatively

• G8703

  Documentation that prophylactic antibiotics were neither given within 4 hours prior to surgical incision nor intraoperatively

• G8704

  12-lead electrocardiogram (ecg) performed

• ---

  ---

  Continued

• G8705

  Documentation of medical reason(s) for not performing a 12-lead electrocardiogram (ecg)

• G8706

  Documentation of patient reason(s) for not performing a 12-lead electrocardiogram (ecg)

• G8707

  12-lead electrocardiogram (ecg) not performed, reason not given

• G8708

  Patient not prescribed antibiotic

• G8709

  Uri episodes when the patient had competing diagnoses on or three days after the episode date (e.g., intestinal infection, pertussis, bacterial infection, lyme disease, otitis media, acute sinusitis, acute pharyngitis, acute tonsillitis, chronic sinusitis, infection of the pharynx/larynx/tonsils/adenoids, prostatitis, cellulitis, mastoiditis, or bone infections, acute lymphadenitis, impetigo, skin staph infections, pneumonia/gonococcal infections, venereal disease (syphilis, chlamydia, inflammatory diseases [female reproductive organs]), infections of the kidney, cystitis or uti, and acne)

• G8710

  Patient prescribed antibiotic

• G8711

  Prescribed antibiotic on or within 3 days after the episode date

• G8712

  Antibiotic not prescribed or dispensed

• G8713

  Spkt/v greater than or equal to 1.2 (single-pool clearance of urea [kt] / volume [v])

• G8714

  Hemodialysis treatment performed exactly three times per week for > 90 days

• G8717

  Spkt/v less than 1.2 (single-pool clearance of urea [kt] / volume [v]), reason not given

• G8718

  Total kt/v greater than or equal to 1.7 per week (total clearance of urea [kt] / volume [v])

• G8720

  Total kt/v less than 1.7 per week (total clearance of urea [kt] / volume [v])

• G8721

  Pt category (primary tumor), pn category (regional lymph nodes), and histologic grade were documented in pathology report

• G8722

  Documentation of medical reason(s) for not including the pt category, the pn category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomasanal canal)

• G8723

  Specimen site is other than anatomic location of primary tumor

• G8724

  Pt category, pn category and histologic grade were not documented in the pathology report, reason not given

• G8725

  Fasting lipid profile performed (triglycerides, ldl-c, hdl-c and total cholesterol)

• G8726

  Clinician has documented reason for not performing fasting lipid profile (e.g., patient declined, other patient reasons)

• G8728

  Fasting lipid profile not performed, reason not given