HCPCS Level II · Procedures and professional services (temporary)
G8561Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About G8561
G8561 is an HCPCS Level II code in the G series (procedures and professional services (temporary)), describing patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure.
It was added to HCPCS effective 01/01/2010.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Pt inelig for ref oto eval
- Date added
- 01/01/2010
- Action effective
- 01/01/2010
- BETOS
- M5D
Related G85xx codes
- G8510Screening for depression is documented as negative, a follow-up plan is not required
- G8511Screening for depression documented as positive, follow-up plan not documented, reason not given
- G8535Elder 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
- G8536No documentation of an elder maltreatment screen, reason not given
- G8539Functional 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
- G8540Functional 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
- G8541Functional outcome assessment using a standardized tool not documented, reason not given
- G8542Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required
- G8543Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
- G8559Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
- G8560Patient has a history of active drainage from the ear within the previous 90 days
- G8562Patient does not have a history of active drainage from the ear within the previous 90 days
Common questions about G8561
Is HCPCS G8561 still valid?
- Yes. G8561 is active in the CMS October 2026 HCPCS file.
Does Medicare cover G8561?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.