G8968 – Documentation of medical reason(s) for not prescribing an fda-approved anticoagulant (e.g., present or planned atrial appendage occlusion or ligation or patient being currently enrolled in a clinical trial related to af/atrial flutter treatment)

Long description

Documentation of medical reason(s) for not prescribing an fda-approved anticoagulant (e.g., present or planned atrial appendage occlusion or ligation or patient being currently enrolled in a clinical trial related to af/atrial flutter treatment)

Short description

Doc med not presb

Pricing indicator

00 Not separately priced by Part B (bundled, not covered or Part A only)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

M5B Specialist - psychiatry

Added

January 1, 2013

Last change

January 1, 2024 – No change

Nearby G codes

• G8960 – Clinician treating major depressive disorder did not communicate to clinician treating comorbid condition, reason not given
• G8961 – Cardiac stress imaging test primarily performed on low-risk surgery patient for preoperative evaluation within 30 days preceding this surgery
• G8962 – Cardiac stress imaging test performed on patient for any reason including those who did not have low risk surgery or test that was performed more than 30 days preceding low risk surgery
• G8963 – Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 years
• G8964 – Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)
• G8965 – Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessment
• G8966 – Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessment
• G8967 – Fda approved oral anticoagulant is prescribed
• G8969 – Documentation of patient reason(s) for not prescribing an oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient preference for not receiving anticoagulation)
• G8970 – No risk factors or one moderate risk factor for thromboembolism
• G8971 – Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not given
• G8972 – One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
• G8973 – Most recent hemoglobin (hgb) level < 10 g/dl
• G8974 – Hemoglobin level measurement not documented, reason not given
• G8975 – Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)
• G8976 – Most recent hemoglobin (hgb) level >= 10 g/dl