Summary & Overview
HCPCS G8670: Upper-Extremity Residual Score Not Measured
HCPCS Level II code G8670 is used to report that a residual functional status score for the elbow, wrist, or hand was not obtained because the patient did not complete the elbow/wrist/hand functional status patient-reported outcome measure at initial evaluation and/or near discharge. Nationally, documenting missing PROMs with a standardized HCPCS Level II code supports quality reporting, outcomes monitoring, and administrative clarity when impairments lack a measured score.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what G8670 represents, the clinical and administrative contexts in which it is applied, common modifiers associated with the service line, and guidance on typical sites of service. The publication provides benchmarks and reporting considerations for outcome measurement in outpatient rehabilitation, outlines coding relationships and common related codes when available, and identifies areas where policy updates or payer guidance may affect documentation practices.
This summary is intended for national audiences involved in medical billing, rehabilitation therapy administration, and quality measurement who need to understand the role of G8670 in capturing missing upper-extremity PROM data.
Billing Code Overview
HCPCS Level II code G8670 indicates a 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. The code documents the absence of a measured functional status patient-reported outcome measure (FS PROM) score for the upper-extremity segments (elbow, wrist, hand) when the patient did not complete the required assessment at initial evaluation and/or near discharge.
Service type: Functional status assessment / outcome reporting for upper extremity (elbow, wrist, hand)
Typical site of service: Outpatient rehabilitation settings or therapy clinics where functional status PROMs are collected during initial evaluation and near discharge
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 57-year-old patient presents to outpatient physical therapy after a distal radius fracture treated surgically three weeks prior. Initial evaluation documentation indicates elbow, wrist, and hand functional segment passive range of motion (FS PROM) testing was planned, but the patient left before completion of the elbow/wrist/hand FS PROM portion of the evaluation and no reason was recorded. At intake the therapist documented pain level, gross ROM of the wrist, and basic ADL limitations but could not complete standardized impairment scoring for the elbow/wrist/hand. During discharge planning two months later the patient again declined or did not complete the elbow/wrist/hand FS PROM assessment and no reason was provided. Billing uses G8670 to report a residual impairment score for the elbow, wrist, or hand that was not measured because the patient did not complete the FS PROM at initial evaluation and/or near discharge and no reason was given. Typical workflow: intake and medical history, attempted comprehensive FS PROM testing of elbow/wrist/hand, documentation that FS PROM was not completed by patient, provision of usual therapeutic interventions, and billing of G8670 to reflect an unmeasured residual score for the affected upper extremity segment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |