HCPCS code G9507 — Doc reas on statin or contra. Status: Active. Effective Jan 1, 2016. Source: CMS HCPCS Level II.

G9507

Active

Doc reas on statin or contra

Documentation that the patient is on a statin medication or has documentation of a valid contraindication or exception to statin medications; contraindications/exceptions that can be defined by diagnosis codes include pregnancy during the measurement period, active liver disease, rhabdomyolysis, end stage renal disease on dialysis and heart failure; provider documented contraindications/exceptions include breastfeeding during the measurement period, woman of child-bearing age not actively taking birth control, allergy to statin, drug interaction (hiv protease inhibitors, nefazodone, cyclosporine, gemfibrozil, and danazol) and intolerance (with supporting documentation of trying a statin at least once within the last 5 years or diagnosis codes for myostitis or toxic myopathy related to drugs)

Category: Procedures
Section: G-codes: Procedures / Professional Services
Effective: Jan 1, 2016
Code type: alphanumeric
OPPS Status: M — Items / services not billable to the fiscal intermediary or MAC