G8968 HCPCS Level II code: Documentation of medical reason(s) for not prescribing an fda-approved anticoagulant (e.g., present or planned atrial appendage occlusion or ligation or…
G8968 is the HCPCS code for “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…” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
G8968Documentation 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
HCPCS · United States
Medicare details
The indicators CMS publishes with G8968 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- Medical care
- BETOS category
- Specialist - psychiatry
- Added
- Jan 1, 2013
Where G8968 sits
- 1G codesProcedures and professional services
- 2Active code G8968Documentation 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)
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code G8968 mean?
G8968 is the HCPCS code for “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)” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover G8968?
CMS lists G8968’s Medicare coverage as “Carrier judgment” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside G8968
All G codesG8962Cardiac 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…G8963Cardiac stress imaging performed primarily for monitoring of asymptomatic patient who had pci within 2 yearsG8964Cardiac 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…G8965Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessmentG8966Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessmentG8967Fda approved oral anticoagulant is prescribedG8969Documentation 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…G8970No risk factors or one moderate risk factor for thromboembolismG8971Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not givenG8972One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolismG8973Most recent hemoglobin (hgb) level < 10 g/dlG8974Hemoglobin level measurement not documented, reason not given