Summary & Overview
HCPCS G8895: Oral Aspirin or Antithrombotic Therapy Prescribed
HCPCS Level II code G8895 denotes the prescription of oral aspirin or other antithrombotic therapy. Nationally, this code captures a common, guideline-driven intervention used for prevention and management of thrombotic risk in cardiovascular and cerebrovascular conditions. Accurate capture of G8895 matters for clinical documentation, population health tracking, and quality measurement.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical service settings, and payer coverage context. The publication summarizes available benchmarks where present, highlights relevant policy or coding updates impacting billing and reporting, and provides clinical context for why documenting antithrombotic prescriptions matters for quality programs and care coordination.
This report is intended for a national audience of clinicians, revenue cycle managers, and policy analysts seeking clarity on the code’s clinical meaning, billing context, and implications for measurement and reporting.
Billing Code Overview
HCPCS Level II code G8895 indicates oral aspirin or other antithrombotic therapy prescribed. This code represents a documented clinical action where a patient receives a prescription for oral aspirin or another antithrombotic medication as part of treatment or secondary prevention.
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Service type: Prescription of antithrombotic therapy
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Typical site of service: Outpatient clinic, primary care, cardiology follow-up, or other ambulatory care settings where medication management and prescriptions are provided
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with a history of atrial fibrillation and prior ischemic stroke who is seen in outpatient cardiology or primary care for secondary stroke prevention. During the visit the clinician documents atrial fibrillation and assesses thromboembolic risk, reviews bleeding risk, and prescribes oral antithrombotic therapy such as aspirin or an oral anticoagulant. The service includes medication selection, patient education on dosing and adverse effects, documentation of counseling, and ordering necessary laboratory monitoring (for warfarin) or follow-up for direct oral anticoagulants. This billing code is used to report that oral aspirin or other antithrombotic therapy was prescribed as part of preventive cardiovascular or cerebrovascular care performed in an ambulatory clinic, hospital outpatient visit, or transitional care visit.
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 an E/M visit is performed and documented in addition to prescribing antithrombotic therapy during the same encounter |
59 | Distinct procedural service |