In simple words: This code is used when a doctor documents the reasons why a patient is not being prescribed a blood thinner to prevent blood clots, even though it's typically recommended. The reasons could include the patient's choice, medical reasons, or other factors.

Documentation of patient reason(s) for not prescribing an oral anticoagulant (e.g. warfarin, apixaban, dabigatran, edoxaban, rivaroxaban) that is FDA approved for the prevention of thromboembolism (e.g., patient preference for not receiving anticoagulation, atrial appendage device placed).

Example 1: A patient with atrial fibrillation refuses to take warfarin due to concerns about bleeding risks. The physician documents the patient's refusal and the discussion about risks and benefits., A patient with a history of gastrointestinal bleeding is considered unsuitable for apixaban. The physician documents the contraindication and explores alternative preventative measures., A patient undergoes placement of an atrial appendage device. Due to this procedure, an oral anticoagulant is deemed unnecessary. The physician documents the rationale for not initiating chronic anticoagulation therapy.

The medical record must clearly document the specific reason(s) for not prescribing an FDA-approved oral anticoagulant, including patient preference, contraindications, alternative therapies, or other relevant factors. The date of the discussion and decision should also be recorded.