2025 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)
TAGS: taking currently hepatic allergy patients pregnancy adverse medication palliative diagnosis receiving renal diabetes intolerance being stage liver fasting therapy disease direct order result active statin patient documentation receive laboratory medical| Notice | HCPCS G9667 terminated on December 31, 2016. |
| Short Description | Doc med rsn no stat tx/presc |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Code Added Date | January 01, 2016 |
| HCPCS Action Effective Date | January 01, 2017 |
| HCPCS Pricing Indicator Code | 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.) |
| HCPCS Type Of Service Code | 1 - Medical care |
| HCPCS Multiple Pricing Indicator Code | 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99') |
| HCPCS Anesthesia Base Unit Quantity | 0 |
| HCPCS Coverage Issues Manual Reference Section Number |
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