HCPCS G8540: Functional Outcome Assessment Not Documented

HCPCS Level II code G8540 documents that a functional outcome assessment was not documented as performed and that the patient was not eligible for a standardized functional outcome assessment at the time of the encounter; this code applies to assessment-related administrative documentation for encounters where the service type is a functional outcome assessment determination and the typical site of service is an outpatient or ambulatory clinical visit where standardized tools would otherwise be used.

For related coverage guidance, see recent payer policy updates: Esophagogastroduodenoscopy (EGD) Coverage Policy, Magnetic Sphincter Augmentation for the Treatment of Gastroesophageal Reflux Disease (GERD), Fecal Analysis in the Diagnosis of Intestinal Dysbiosis and Fecal Microbiota Transplant Testing.