How To Use HCPCS Code G9664

HCPCS code G9664 describes patients who are currently using statin therapy or have received a prescription for statin therapy. This code is used to identify individuals who are taking statin medication or have been advised to start taking it. In this article, we will explore the details of HCPCS code G9664, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS G9664?

HCPCS code G9664 is used to indicate patients who are currently on statin therapy or have received an order (prescription) for statin therapy. It helps healthcare providers identify individuals who are taking or have been advised to take statin medication to manage their cholesterol levels.

2. Official Description

The official description of HCPCS code G9664 is “Patients who are currently statin therapy users or received an order (prescription) for statin therapy.” The short description is “Taking statin or rec’d order.”

3. Procedure

1. Patients who are currently on statin therapy: Healthcare providers should document the patient’s current statin therapy regimen, including the specific medication, dosage, and frequency of use.
2. Patients who have received an order (prescription) for statin therapy: Healthcare providers should document the details of the prescription, including the prescribed statin medication, dosage, and any specific instructions provided.

4. When to use HCPCS code G9664

HCPCS code G9664 should be used when documenting patients who are currently using statin therapy or have received a prescription for statin therapy. It is important to accurately capture this information to ensure proper coding and billing for the services provided.

5. Billing Guidelines and Documentation Requirements

Healthcare providers should ensure proper documentation of the patient’s statin therapy status or prescription for statin therapy. This includes recording the specific statin medication, dosage, frequency of use, and any relevant instructions. When billing for services related to statin therapy, providers should use HCPCS code G9664 to indicate the patient’s statin therapy status or prescription.

6. Historical Information and Code Maintenance

HCPCS code G9664 was added to the Healthcare Common Procedure Coding System on January 01, 2016. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code G9664 may vary. Providers should consult the applicable coverage policies and guidelines to determine if the services related to statin therapy are reimbursable. The pricing indicator code for HCPCS code G9664 is 00, which indicates that the service is not separately priced by Part B. Providers should follow the reimbursement guidelines provided by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code G9664 should be billed:

1. A patient is currently taking atorvastatin 20mg once daily for cholesterol management.
2. A patient has been prescribed rosuvastatin 10mg daily to control their cholesterol levels.
3. A patient is on simvastatin 40mg twice daily as part of their statin therapy regimen.
4. A physician prescribes pravastatin 20mg once daily to a patient with high cholesterol.
5. A patient receives a prescription for lovastatin 40mg to be taken every evening for cholesterol control.