HCPCS G9724: Anticoagulant Medication Use Documented Over Measurement Year - OpenPayer

Summary & Overview

HCPCS G9724: Anticoagulant Medication Use Documented Over Measurement Year

HCPCS Level II code G9724 identifies patients with documentation of anticoagulant medication use that overlaps the measurement year. This measure captures medication exposure relevant to stroke prevention, atrial fibrillation management, venous thromboembolism care, and other conditions requiring anticoagulation. Nationally, clear documentation of anticoagulant use affects quality measurement, care coordination, and population health reporting.

Key payers assessed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis focuses on adoption patterns across major commercial and public payers, implications for reporting workflows, and how this measure integrates with outpatient medication reconciliation and chronic disease management.

Readers will learn the clinical context of G9724, typical sites of service where it applies, and the role it plays in quality measurement and reporting. The publication outlines common billing and documentation considerations, describes what information is available for payers in this review, and flags areas where input data was not provided. This summary supports administrative staff, clinicians, and compliance teams seeking a concise national overview of the code’s purpose and relevance for quality reporting.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareG9724HCPCS Level IIanticoagulantmedication documentationquality measureoutpatient caremedication reconciliation

Billing Code Overview

HCPCS Level II code G9724 documents patients who had documentation of use of anticoagulant medications overlapping the measurement year. This code represents a performance or quality measure indicating that a patient had active anticoagulant therapy recorded during the specified reporting period.

Service type: Medication exposure documentation and quality reporting
Typical site of service: Ambulatory clinics, outpatient visits, primary care settings, and other outpatient care environments where medication histories and chronic medication management are recorded.

Clinical & Coding Specifications

Clinical Context

A 72-year-old male with atrial fibrillation and a history of ischemic stroke attends a primary care visit and medication reconciliation during the measurement year. The clinician documents ongoing anticoagulant therapy (for example, warfarin, apixaban, rivaroxaban, dabigatran, or edoxaban) that overlaps the measurement year to meet quality reporting. Clinical workflow: medication list reconciliation in ambulatory primary care or cardiology; review of pharmacy fill records and patient report; documentation in the electronic health record of anticoagulant name, dose, start date and evidence of continued use during the report period. Typical site of service: outpatient clinic (primary care, cardiology) or anticoagulation management clinic; documentation may also be confirmed via telephone encounter or telehealth visit that is captured in the chart.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required to document anticoagulant therapy overlapped with unusually increased effort (apply per payer rules).
`23`	Unusual anesthesia	Rarely applicable; only when a procedure requiring anesthesia occurred in conjunction with anticoagulation documentation and anesthesia was medically unusual.

HCPCS G9982: Remote In-Home New Patient Evaluation and Management

HCPCS-G9468-NO-PROLONGED-CORTICOSTEROID-EXPOSURE

HCPCS G9468: No Prolonged or High-Cumulative Corticosteroid Exposure

HCPCS-G9426-ED-PAIN-MEDICATION-TIMING-IMPROVEMENT

HCPCS G9426: ED Pain Medication Timing Improvement

HCPCS-G9721-WHEELCHAIR-BOUND-NON-AMBULATORY-STATUS

HCPCS G9721: Non-ambulatory / Wheelchair-Bound Functional Status

HCPCS-G0037-ASSESSMENT-SCREENING-PATIENT-UNABLE-TO-PARTICIPATE-NO-INFORMANT

HCPCS G0037: Assessment/Screening Not Feasible — Patient Unable to Participate

HCPCS-G0109-DIABETES-GROUP-SELF-MANAGEMENT-30-MIN

HCPCS G0109: Diabetes Outpatient Group Self-Management, per 30 Minutes

HCPCS-G8798-NONPROSTATE-SPECIMEN-SITE

HCPCS G8798: Specimen Site Other Than Anatomic Location of Prostate

HCPCS-G8960-MAJOR-DEPRESSIVE-DISORDER-COMMUNICATION-NOT-DOCUMENTED

HCPCS G8960: Clinician Non-Communication in Major Depressive Disorder

HCPCS-G0493-SKILLED-NURSING-OBSERVATION-ASSESSMENT-HOME-HEALTH-HOSPICE

HCPCS G0493: Skilled Nursing Observation and Assessment, per 15 minutes

HCPCS-G8696-ANTITHROMBOTIC-THERAPY-PRESCRIBED-AT-DISCHARGE

HCPCS G8696: Antithrombotic Therapy Prescribed at Discharge

Showing 1–10 of 1996

Taxonomy Code	Specialty	Notes
`207Q00000X`	Family Medicine	Primary care clinicians who document outpatient anticoagulant use.
`207R00000X`	Internal Medicine	Internists managing chronic anticoagulation for medical conditions.
`207RP1001X`	Cardiology	Cardiologists documenting anticoagulation for atrial fibrillation or thromboembolic disease.
`207L00000X`	Emergency Medicine	Emergency clinicians who document anticoagulant use during acute visits.
`207K00000X`	Hematology	Hematologists who oversee anticoagulation decisions for complex coagulopathies.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

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, moderate complexity	Common outpatient E/M visit where anticoagulant use is reconciled and documented.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate, greater than 3 minutes up to 10 minutes	Ancillary counseling that may occur during an anticoagulation management visit (behavioral risk counseling documented alongside medication use).
`99407`	Smoking and tobacco use cessation counseling visit, intensive, greater than 10 minutes	Longer counseling sessions that can accompany anticoagulant education and documentation.
`93792`	Anticoagulation management service(s) per calendar month, monitoring and adjustment(s) of anticoagulant therapy for patient on oral anticoagulants	Directly relates to the management and documentation of ongoing anticoagulant therapy across the measurement year.
`36415`	Collection of venous blood by venipuncture	Laboratory testing (INR, renal function) commonly performed when monitoring anticoagulant therapy and documented during the measurement year.

OpenPayer