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HCPCS G8697

Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))

HCPCS G8697 CMS Temporary Procedures & Professional Services

Description

Antithrombotic therapy not prescribed for documented reasons (e.g., patient had stroke during hospital stay, patient expired during inpatient stay, other medical reason(s)); (e.g., patient left against medical advice, other patient reason(s))

Common Specialties

Emergency Medicine, Physical Therapy, Neurology

Documentation Requirements

  • Document clinical indications and clear medical necessity supporting the encounter or procedure.
  • Ensure complete provider signatures, credentials, date, and specific place of service (POS).
  • Verify documentation strictly supports code specificity to prevent downcoding or claim denials.

Billing & Coding Tips

  • Verify current payer fee schedules, NCCI edits, and Medically Unlikely Edits (MUEs).
  • Append correct modifiers (e.g., 25, 59, 26, TC) where distinct procedural services or components apply.
  • Confirm pre-authorization rules with Medicare, Medicaid, and commercial plans before submission.

Related Codes

G8001 G8002 G8126 G8127 G8128 G8395 G8396 G8397 G8398 G8399 G8400 G8401 G8404 G8405 G8406

Quantum Health Services provides full-cycle revenue cycle management and medical billing services nationwide. This code reference is for educational purposes; always verify official payer policies. CPT© descriptors require proper AMA licensing.