Summary & Overview
HCPCS G8764: Completion of Cardiovascular Prevention Measures
HCPCS Level II code G8764 denotes that a patient has received all required quality actions within the cardiovascular prevention measures group. This code documents completion of preventive cardiovascular care processes that contribute to quality reporting and population health management. Nationally, such codes support metric-driven programs aimed at reducing cardiovascular risk and help providers and payers track adherence to evidence-based preventive measures.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical role of the code, how it is used in outpatient and ambulatory settings, and what its presence in claims signifies for quality reporting and care coordination. The publication covers benchmark use cases, reporting and documentation implications, and any recent policy updates affecting HCPCS-level quality reporting codes.
This summary is intended to clarify the clinical and administrative purpose of G8764, outline where it commonly appears in the care continuum, and describe what stakeholders can infer from its use on claims and quality submissions.
Billing Code Overview
HCPCS Level II code G8764 indicates that all quality actions for the applicable measures in the cardiovascular prevention measures group have been performed for this patient. The service type is quality reporting/documentation of cardiovascular prevention care completion. The typical site of service is outpatient or ambulatory settings where preventive cardiovascular measures are tracked and reported, including primary care clinics and cardiology outpatient practices.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with established cardiovascular risk factors—such as hypertension, hyperlipidemia, diabetes mellitus, or a history of smoking—attending a primary care or cardiology visit for cardiovascular prevention care. During the visit the clinician documents and completes all required quality actions for the cardiovascular prevention measures group: blood pressure measurement and control assessment, tobacco use screening and cessation counseling or intervention, lipid panel ordering or review with statin therapy reconciliation when indicated, aspirin use assessment when appropriate, weight/BMI assessment, counseling on diet and exercise, and documentation of medication reconciliation and adherence. The workflow typically includes nursing staff obtaining vitals and smoking status, laboratory orders for fasting lipids if due, clinician review of results and medication list, counseling and shared decision-making, and completion of structured EHR quality measure fields so that the claim can be reported with G8764 indicating that all applicable cardiovascular prevention measures were performed for the patient during the reporting period.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service | Use when a significant E/M is performed in addition to preventive care activities documented for cardiovascular measures |
59 | Distinct procedural service | Use when a separately identifiable procedural service is performed the same day as cardiovascular prevention activities |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Rarely used; applicable only if a related unplanned procedure occurs after an index procedure on the same episode |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period while cardiovascular prevention services are reported |
24 | Unrelated E/M service by the same physician during a postoperative period | Use if an unrelated E/M is provided during a global period alongside prevention measure reporting |
GT | Via interactive audio and video telecommunication (telehealth) | Use when cardiovascular prevention measures are completed via synchronous telehealth |
95 | Synchronous telemedicine service rendered via real-time interactive audio and video | Alternative telehealth modifier for payer-specific requirements |
KX | Requirements specified in the medical policy have been met | Use when payer policy requires attestation that preventive measure conditions are satisfied |
GA | Waiver of liability statement issued, voluntary under payer policy | Use when patient has been informed and waived cost-sharing for certain services related to prevention measures per payer rules |
G0 | Telehealth diagnosis or procedure normally furnished in-person but provided via telehealth due to a federal public health emergency | Use when measures are completed via telehealth under emergency flexibilities |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207Q00000X | Family Medicine | Primary clinicians who commonly perform preventive cardiovascular care |
207R00000X | Internal Medicine | Primary care internists managing cardiovascular risk and measures |
207RC0000X | Cardiovascular Disease (Cardiology) | Specialists who perform cardiovascular risk assessment and secondary prevention management |
363LF0000X | Nurse Practitioner | Advanced practice providers who frequently complete preventive measures and documentation |
204R00000X | Physician Assistant | Mid-level providers participating in preventive cardiovascular workflows |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I10 | Essential (primary) hypertension | Hypertension is a primary cardiovascular risk factor; blood pressure assessment and control are central to prevention measures |
E78.5 | Hyperlipidemia, unspecified | Dyslipidemia prompts lipid testing and statin therapy considerations included in prevention measures |
E11.9 | Type 2 diabetes mellitus without complications | Diabetes increases cardiovascular risk; preventive measures include tighter risk factor management |
Z72.0 | Tobacco use, current | Current tobacco use requires screening and cessation interventions as part of cardiovascular prevention |
Z13.6 | Encounter for screening for cardiovascular disorders | Used when patient is seen specifically for cardiovascular risk screening and preventive measure completion |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
99213 | Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes | Common E/M level used when performing and documenting cardiovascular prevention counseling and medication reconciliation alongside measure completion |
99406 | Smoking and tobacco use cessation counseling, intermediate, greater than 3 minutes up to 10 minutes | Used when tobacco cessation counseling is provided as part of the cardiovascular prevention measures |
80061 | Lipid panel (cholesterol, HDL, triglycerides) | Laboratory test commonly ordered and reviewed as part of cardiovascular risk assessment and measure documentation |
36415 | Collection of venous blood by venipuncture | Performed when blood is drawn for lipid panel or other testing supporting cardiovascular prevention measures |
99401 | Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual, approximately 15 minutes | Used when brief preventive counseling on diet, exercise, or risk reduction is documented as part of the measures |
G0438 | Annual wellness visit, first visit | Preventive visit code during which comprehensive cardiovascular prevention measures are often completed and documented |