G8665 — Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
G8665 is a HCPCS Level II code for risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2019 and is not valid on new claims.
This code has been terminated
CMS terminated G8665 on December 31, 2019. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
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.
The CMS record for G8665
- Long descriptor
- Risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
- Short descriptor
- Rafscrs si no scor
- Added
- January 1, 2011
- Terminated
- December 31, 2019
- BETOS
- M5B
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8665
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8665 is not quite right, the correct code is very often within a few positions of it.
- G8657Risk-adjusted functional status change residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriateterminated
- G8658Residual score for the lower leg, foot or ankle impairment not measured because the patient did not complete the lepf prom at initial evaluation and/or near discharge, reason not given
- G8659Residual score for the low back impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
- G8660Residual score for the low back impairment successfully calculated and the score was less than zero (< 0)
- G8661Risk-adjusted functional status change residual score for the low back impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate
- G8662Residual score for the low back impairment not measured because the patient did not complete the low back fs prom at initial evaluation and/or near discharge, reason not given
- G8663Residual score for the shoulder impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
- G8664Residual score for the shoulder impairment successfully calculated and the score was less than zero (< 0)
- G8666Residual score for the shoulder impairment not measured because the patient did not complete the shoulder fs prom at initial evaluation and/or near discharge, reason not given
- G8667Residual score for the elbow, wrist or hand impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)
- G8668Residual score for the elbow, wrist or hand impairment successfully calculated and the score was less than zero (< 0)
- G8669Risk-adjusted functional status change residual score for the elbow, wrist or hand impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriateterminated
- G8670Residual 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
- G8671Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was equal to zero (0) or greater than zero (> 0)terminated
- G8672Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment successfully calculated and the score was less than zero (< 0)terminated
- G8673Risk-adjusted functional status change residual score for the neck, cranium, mandible, thoracic spine, ribs or other general orthopedic impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriateterminated
Questions about G8665
What is HCPCS code G8665?
G8665 is a HCPCS Level II code for risk-adjusted functional status change residual score for the shoulder impairment not measured because the patient did not complete the fs status survey near discharge, patient not appropriate. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8665?
The CMS HCPCS file marks G8665 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.
Is G8665 still valid?
No. G8665 was terminated on December 31, 2019 and should not be used on new claims.