Table of content for "Doc reas on statin or contra" (HCPCS G9507)
General information on the “G9507” code
HCPCS Code: G9507
Long Description: 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)
Short Description: Doc reas on statin or contra
Original information is taken from G9507 page
Pricing indicators
Pricing Indicator Code 1: 00 – Service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.)
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')
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): Z2 – Undefined codes
Type Of Service 1: 1 – Medical care
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20160101
Code Effective Date: 20160101
Action Code: N – No maintenance for this code