How To Use HCPCS Code G8895

HCPCS code G8895 describes the oral administration of aspirin or other antithrombotic therapy that is prescribed by a healthcare provider. This code is used to identify the specific treatment provided to patients who require antithrombotic therapy to prevent blood clots or reduce the risk of cardiovascular events. In this article, we will explore the details of HCPCS code G8895, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G8895?

HCPCS code G8895 is a specific code used in medical coding to identify the oral administration of aspirin or other antithrombotic therapy that is prescribed by a healthcare provider. This code is essential for accurately documenting and billing for the antithrombotic therapy provided to patients.

2. Official Description

The official description of HCPCS code G8895 is “Oral aspirin or other antithrombotic therapy prescribed.” This description clearly indicates that this code is used to represent the prescription and administration of oral antithrombotic therapy, such as aspirin, to patients.

3. Procedure

1. The healthcare provider assesses the patient’s medical history, risk factors, and overall health condition to determine the need for antithrombotic therapy.
2. If the provider determines that the patient would benefit from oral antithrombotic therapy, they prescribe the appropriate medication, such as aspirin or other antithrombotic agents.
3. The patient receives a prescription for the oral antithrombotic therapy and is instructed on the proper dosage and administration.
4. The patient obtains the prescribed medication from a pharmacy or healthcare facility.
5. The patient takes the medication orally as directed by the healthcare provider.
6. The healthcare provider monitors the patient’s response to the antithrombotic therapy and adjusts the treatment plan if necessary.

4. When to use HCPCS code G8895

HCPCS code G8895 should be used when a healthcare provider prescribes oral aspirin or other antithrombotic therapy to a patient. This code is applicable in situations where the provider determines that the patient would benefit from antithrombotic therapy to prevent blood clots or reduce the risk of cardiovascular events.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G8895, healthcare providers need to document the prescription of oral aspirin or other antithrombotic therapy, including the specific medication prescribed and the dosage instructions. Additionally, providers should include relevant patient information, such as medical history, risk factors, and any other supporting documentation that justifies the need for antithrombotic therapy.

6. Historical Information and Code Maintenance

HCPCS code G8895 was added to the Healthcare Common Procedure Coding System on January 1, 2012. It has an effective date of January 1, 2015, indicating that it was terminated on December 31, 2014. This code has no maintenance actions, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G8895 may vary. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service may not be covered or may be bundled with other services. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G8895 should be billed:

1. A patient with a history of cardiovascular disease is prescribed oral aspirin therapy by their cardiologist to reduce the risk of future cardiovascular events.
2. A patient undergoes a coronary artery bypass graft surgery and is prescribed oral antithrombotic therapy as part of their postoperative care.
3. A patient with a high risk of developing blood clots due to a medical condition, such as atrial fibrillation, is prescribed oral anticoagulant therapy.
4. A patient with a recent stroke is prescribed oral aspirin therapy to prevent further clot formation and reduce the risk of recurrent strokes.
5. A patient with peripheral artery disease is prescribed oral antithrombotic therapy to improve blood flow and reduce the risk of complications.