2025 HCPCS code G9796
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Quality Measure Tracking - Performance Measurement Additional Assorted Quality Measures Feed
Tracks whether a patient is currently on statin therapy.
Modifiers are not applicable to this code.
Medical necessity is not relevant as this is a reporting code, not a billable procedure.
The clinical responsibility lies with the physician or healthcare provider documenting the patient's medication status. Accurate documentation is crucial for appropriate reporting.
- Additional Assorted Quality Measures
- G9796 falls under the broader category of Additional Assorted Quality Measures within the HCPCS coding system.
In simple words: This code tells if a patient is taking cholesterol-lowering medicine (a statin). It's for tracking how well doctors are doing, not for billing.
This HCPCS code is used to report whether a patient is currently receiving statin therapy.Statins are medications that lower cholesterol levels.This code is primarily for performance measurement and quality reporting purposes and is typically zero-priced.
Example 1: A patient presents for a routine check-up. The physician notes the patient is currently on atorvastatin and codes G9797., A patient is newly diagnosed with high cholesterol and has not started statin therapy yet. The provider codes G9796., During a chart review for a quality reporting initiative, the medical coder reviews patient medical records and assigns code G9796 or G9797 based on documented medication information.
Documentation should clearly indicate whether or not the patient is currently taking a statin medication.This could include the prescription, medication reconciliation documentation, or physician's note.
** This code is not used for billing. It solely serves as a tracking mechanism for performance measurement related to statin therapy.
- Revenue Code: No specific revenue codes are directly associated with this tracking code as it does not represent a billable service.
- RVU: Zero RVUs; this code is not used for direct reimbursement.
- Global Days: Not applicable. This is a tracking code, not a procedure.
- Payment Status: Zero-priced.Not reimbursable.
- Modifier TC rule: Technical component modifiers are not applicable.
- Fee Schedule: This code is zero-priced and has not had a historical fee schedule.
- Specialties:All specialties involved in managing hyperlipidemia may use this code for reporting purposes.
- Place of Service:Any place of service where patient medical records are maintained and accessed for quality reporting.