G8858 Not ref for otological evaluation
Also known as: ENT referral not made, otolaryngology referral missed, ENT evaluation not ordered
Performance measure indicating patient was not referred for otolaryngologic evaluation despite meeting clinical criteria.
In Plain Language
patient needed an ear, nose, and throat doctor but was not referred; missed ENT referral
Clinical Context
Tracks cases where otolaryngologic referral would have been appropriate but was not completed, used for quality measure compliance.
RVU Information
CPT G8858 does not have a physician work RVU assigned by CMS. Reimbursement for this code is determined by payer-specific fee schedules.
Billing & Documentation
G-codes are CMS-specific HCPCS codes for services not covered by standard CPT. Documentation requirements follow the same standards as the equivalent CPT service. Check Medicare LCD/NCD policies for coverage criteria.
How This Code Compares
This code has a work RVU of 0.00, meaning it does not have a physician work component assigned by CMS. In the G Codes category, 85% of codes share this characteristic.
Specialties
Frequently Asked Questions
What is CPT code G8858?
CPT G8858 (Not ref for otological evaluation) is a G Codes code. Performance measure indicating patient was not referred for otolaryngologic evaluation despite meeting clinical criteria.
Who uses CPT code G8858?
CPT G8858 is used by Primary Care, Care Coordination, Quality Reporting. Tracks cases where otolaryngologic referral would have been appropriate but was not completed, used for quality measure compliance.
When is CPT G8858 used?
Tracks cases where otolaryngologic referral would have been appropriate but was not completed, used for quality measure compliance.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.