How To Use HCPCS Code G9665

HCPCS code G9665 describes patients who are not currently using statin therapy or have not received a prescription for statin therapy. This code is used to indicate that the patient does not fall into the category of statin therapy users or has not been prescribed statin therapy. In this article, we will explore the details of HCPCS code G9665, 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 G9665?

HCPCS code G9665 is used to identify patients who are not currently using statin therapy or have not received a prescription for statin therapy. It is important to accurately assign this code to ensure proper documentation and billing for patients who do not fall into the category of statin therapy users.

2. Official Description

The official description of HCPCS code G9665 is “Patients who are not currently statin therapy users or did not receive an order (prescription) for statin therapy.” The short description for this code is “No statin/no order statin.”

3. Procedure

  1. When assigning HCPCS code G9665, the healthcare provider should review the patient’s medical records to determine if they are currently using statin therapy or if they have received a prescription for statin therapy.
  2. If the patient is not currently using statin therapy or has not received a prescription for statin therapy, HCPCS code G9665 should be assigned.
  3. Ensure that the documentation clearly supports the non-usage or absence of a prescription for statin therapy.

4. When to use HCPCS code G9665

HCPCS code G9665 should be used when the patient is not currently using statin therapy or has not received a prescription for statin therapy. It is important to accurately identify patients who do not fall into the category of statin therapy users to ensure proper documentation and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code G9665, healthcare providers should ensure that the documentation clearly supports the non-usage or absence of a prescription for statin therapy. This may include medical records, progress notes, or any other relevant documentation that confirms the patient’s status regarding statin therapy.

6. Historical Information and Code Maintenance

HCPCS code G9665 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

HCPCS code G9665 is covered by Medicare and other insurance providers. The pricing indicator code for this code is 00, which means the service is not separately priced by Part B. This indicates that the service is bundled or not covered separately. The multiple pricing indicator code is 9, which means it is not applicable as HCPCS code G9665 is not priced separately by Part B or the value is not established.

8. Examples

Here are five examples of when HCPCS code G9665 should be billed:

  1. A patient who has never been prescribed statin therapy and does not currently use it.
  2. A patient who previously used statin therapy but has discontinued it and does not currently have a prescription for it.
  3. A patient who has a contraindication to statin therapy and has not been prescribed it.
  4. A patient who has not been assessed for statin therapy and does not currently use it.
  5. A patient who is not eligible for statin therapy based on clinical guidelines and does not currently use it.

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