HCPCS Code G9667
Documentation of medical reason(s) for not currently being a statin therapy user or receive an order (prescription) for statin therapy (e.g., patient with adverse effect, allergy or intolerance to statin medication therapy, patients who have an active diagnosis of pregnancy or who are breastfeeding, patients who are receiving palliative care, patients with active liver disease or hepatic disease or insufficiency, patients with end stage renal disease (esrd), and patients with diabetes who have a fasting or direct ldl-c laboratory test result < 70 mg/dl and are not taking statin therapy)
| Short Description | Doc med rsn no stat tx/presc |
|---|---|
| Year | 2026 |
| Coverage Code | C = Carrier judgment |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2017 |
| Code Added Date | January 01, 2016 |
| Pricing Indicator | 00 = Service not separately priced by Part B (e.g., services not covered, bundled, used by part a only, etc.) |
| Type of Service | 1 = Medical care |