G8559

G8559 — Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation

HCPCSActiveBETOS M5D

G8559 is a HCPCS Level II code for patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation. It belongs to the Procedures and Professional Services (Temporary) section. Whether Medicare pays it depends on the coverage rule below.

Medicare coverage: Carrier judgment

Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.

Physician fee schedule statusI

Not valid for Medicare purposes. Medicare uses another code.

Global period: XXX

Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.

The CMS record for G8559

Long descriptor: Patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation
Short descriptor: Pt ref doc oto eval
Added: January 1, 2010
BETOS: M5D
Pricing indicator: 00 — Not priced by Part B

Codes adjacent to G8559

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8559 is not quite right, the correct code is very often within a few positions of it.

G8543Documentation of a positive functional outcome assessment using a standardized tool; care plan not documented within two days of assessment, reason not given
G8544I intend to report the coronary artery bypass graft (cabg) measures groupterminated
G8545I intend to report the hepatitis c measures groupterminated
G8547I intend to report the ischemic vascular disease (ivd) measures groupterminated
G8548I intend to report the heart failure (hf) measures groupterminated
G8549All quality actions for the applicable measures in the hepatitis c measures group have been performed for this patientterminated
G8551All quality actions for the applicable measures in the heart failure (hf) measures group have been performed for this patientterminated
G8552All quality actions for the applicable measures in the ischemic vascular disease (ivd) measures group have been performed for this patientterminated
G8560Patient has a history of active drainage from the ear within the previous 90 days
G8561Patient is not eligible for the referral for otologic evaluation for patients with a history of active drainage measure
G8562Patient does not have a history of active drainage from the ear within the previous 90 days
G8563Patient not referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not given
G8564Patient was referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation, reason not specified)
G8565Verification and documentation of sudden or rapidly progressive hearing loss
G8566Patient is not eligible for the "referral for otologic evaluation for sudden or rapidly progressive hearing loss" measure
G8567Patient does not have verification and documentation of sudden or rapidly progressive hearing loss

Questions about G8559

What is HCPCS code G8559?

G8559 is a HCPCS Level II code for patient referred to a physician (preferably a physician with training in disorders of the ear) for an otologic evaluation. It sits in the Procedures and Professional Services (Temporary) section.

Does Medicare cover G8559?

The CMS HCPCS file marks G8559 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.

How is G8559 paid under the physician fee schedule?

G8559 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.