G8972 — One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
G8972 is a HCPCS Level II code for one or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism. It belongs to the Procedures and Professional Services (Temporary) section. It was terminated on December 31, 2017 and is not valid on new claims.
This code has been terminated
CMS terminated G8972 on December 31, 2017. It stays in the file as history — a claim you are auditing from before that date may legitimately carry it — but it must not appear on a new claim. The adjacent codes below are the usual place to look for its replacement.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
The CMS record for G8972
- Long descriptor
- One or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism
- Short descriptor
- 1>=risk or>= mod risk for te
- Added
- January 1, 2013
- Terminated
- December 31, 2017
- BETOS
- M5B
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
When CMS retired it.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to G8972
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If G8972 is not quite right, the correct code is very often within a few positions of it.
- G8964Cardiac stress imaging test performed primarily for any other reason than monitoring of asymptomatic patient who had pci within 2 years (e.g., symptomatic patient, patient greater than 2 years since pci, initial evaluation, etc)terminated
- G8965Cardiac stress imaging test primarily performed on low chd risk patient for initial detection and risk assessmentterminated
- G8966Cardiac stress imaging test performed on symptomatic or higher than low chd risk patient or for any reason other than initial detection and risk assessmentterminated
- G8967Fda approved oral anticoagulant is prescribed
- G8968Documentation of medical reason(s) for not prescribing an fda-approved anticoagulant (e.g., present or planned atrial appendage occlusion or ligation or patient being currently enrolled in a clinical trial related to af/atrial flutter treatment)
- G8969Documentation of patient reason(s) for not prescribing an oral anticoagulant that is fda approved for the prevention of thromboembolism (e.g., patient preference for not receiving anticoagulation)
- G8970No risk factors or one moderate risk factor for thromboembolism
- G8971Warfarin or another oral anticoagulant that is fda approved not prescribed, reason not giventerminated
- G8973Most recent hemoglobin (hgb) level < 10 g/dlterminated
- G8974Hemoglobin level measurement not documented, reason not giventerminated
- G8975Documentation of medical reason(s) for patient having a hemoglobin level < 10 g/dl (e.g., patients who have non-renal etiologies of anemia [e.g., sickle cell anemia or other hemoglobinopathies, hypersplenism, primary bone marrow disease, anemia related to chemotherapy for diagnosis of malignancy, postoperative bleeding, active bloodstream or peritoneal infection], other medical reasons)terminated
- G8976Most recent hemoglobin (hgb) level >= 10 g/dlterminated
- G8977I intend to report the oncology measures groupterminated
- G8978Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervalsterminated
- G8979Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reportingterminated
- G8980Mobility: walking & moving around functional limitation, discharge status, at discharge from therapy or to end reportingterminated
Questions about G8972
What is HCPCS code G8972?
G8972 is a HCPCS Level II code for one or more high risk factors for thromboembolism or more than one moderate risk factor for thromboembolism. It sits in the Procedures and Professional Services (Temporary) section.
Does Medicare cover G8972?
The CMS HCPCS file marks G8972 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
Is G8972 still valid?
No. G8972 was terminated on December 31, 2017 and should not be used on new claims.