G9928 Warfarin or another fda-approved anticoagulant not prescribed, reason not given

HCPCS Code G9928: Warfarin or Another FDA-Approved Anticoagulant Not Prescribed, Reason Not Given

HCPCS code G9928 represents a quality reporting action indicating that warfarin or another FDA-approved anticoagulant was not prescribed, and no reason was given. It is utilized within the atrial fibrillation and atrial flutter chronic anticoagulation therapy measure to document performance not met. 1 2 3 4

Plain-language overview

Code G9928 communicates that a patient did not receive a prescription for warfarin or another FDA-approved anticoagulant, and the medical record or claim lacks a stated reason for this omission. 1 3

What this code represents

Within the atrial fibrillation and atrial flutter measure, G9928 specifically represents the numerator option for performance not met, used when an anticoagulant is not prescribed and no exception is documented. 1 2

Coding details

The reporting logic for this measure dictates that if an anticoagulant is not prescribed and no medical, patient, or system reason is documented, the submission proceeds to check G9928 for performance not met. 1 2

In sample calculations for this quality measure, submitting G9928 accounts for patients meeting data completeness but falling into the performance not met category, directly impacting the performance rate. 1

Documentation considerations

To avoid reporting G9928, documentation must capture a valid medical, patient, or system reason for not prescribing the anticoagulant, such as a medical contraindication or patient enrollment in a relevant clinical trial. 1 2

If no qualifying exception is documented to explain the absence of the anticoagulant prescription, G9928 is submitted to satisfy data completeness requirements for the eligible patient encounter. 1 2

What the sources add

While official measure specifications detail the complex denominator and numerator logic for G9928, provider newsletters and code change reviews simply list the code and its description for general awareness. 1 3 4

The 2021 measure specification adds denominator exclusions for comfort care and specific CHA2DS2-VASc risk scores, whereas the 2018 specification focuses on medical, patient, and system exceptions for the anticoagulant prescription. 1 2

Sources

1. Quality ID #326 (NQF 1525): Atrial Fibrillation and Atrial Flutter — qpp.cms.gov; accessed 2026-07-27.
2. Atrial Fibrillation and Atrial Flutter: Chronic Anticoagulation ... — qpp.cms.gov; accessed 2026-07-27.
3. Connection - provider newsletter - January 2018 — fallonhealth.org; accessed 2026-07-27.
4. Review of CDM Code Changes Effective Jan. 2018 — stroudwater.com; accessed 2026-07-27.