HCPCS G9667 Code. Doc med rsn no stat tx/presc

HCPCS Code: G9667
Long Description: 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

Original information is taken from G9667 page

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')

Coverage: C – Carrier judgment

Berenson-Eggers Type of Service (BETOS): Z2 – Undefined codes
Type Of Service 1: 1 – Medical care

Anesthesia Base Unit Quantity: 0
Code Added Date: 20160101
Code Effective Date: 20170101
Termination Date: 20161231
Action Code: N – No maintenance for this code