ICD-10 Coding for Atorvastatin Use and Adverse Effects(T46.6X5A, Z79.899, Z91.130)
Complete ICD-10-CM coding and documentation guide for Atorvastatin Use and Adverse Effects. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Atorvastatin Use and Adverse Effects
T46.6X5Primary Range
Adverse effects of antihyperlipidemic and antiarteriosclerotic drugs
Used for coding adverse effects related to atorvastatin.
Patient's intentional underdosing of medication regimen due to side effects
Used when a patient reduces atorvastatin dosage due to side effects.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| T46.6X5A | Adverse effect of antihyperlipidemic and antiarteriosclerotic drugs, initial encounter | Use when a patient experiences an adverse effect from atorvastatin. |
|
| Z79.899 | Other long term (current) drug therapy | Use for patients on long-term atorvastatin therapy. |
|
| Z91.130 | Patient's intentional underdosing of medication regimen due to side effects | Use when a patient intentionally reduces atorvastatin dosage due to side effects. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for atorvastatin adverse effects
Essential facts and insights about Atorvastatin Use and Adverse Effects
Primary ICD-10-CM Codes for atorvastatin
Decision Criteria
clinical Criteria
- Presence of adverse symptoms post-atorvastatin initiation
documentation Criteria
- Detailed symptom description and lab results
Applicable To
- Adverse effects of atorvastatin
Excludes
- Overdose of antihyperlipidemic drugs
Clinical Validation Requirements
- Documented causality between atorvastatin and adverse effect
- Objective findings such as elevated CK levels
Code-Specific Risks
- Incorrect sequencing with primary diagnosis
- Failure to document causality
Coding Notes
- Ensure documentation of adverse effect onset and clinical findings.
Z79.899 - Other long term (current) drug therapy
Use for patients on long-term atorvastatin therapy.
Applicable To
- Long-term use of atorvastatin
Excludes
- Short-term drug therapy
Clinical Validation Requirements
- Documented long-term prescription of atorvastatin
Coding Notes
Ensure the duration of therapy is clearly documented.
Z91.130 - Patient's intentional underdosing of medication regimen due to side effects
Use when a patient intentionally reduces atorvastatin dosage due to side effects.
Applicable To
- Underdosing atorvastatin due to side effects
Excludes
- Non-intentional underdosing
Clinical Validation Requirements
- Patient-reported dose reduction
- Provider acknowledgment of side effects
Coding Notes
Document patient-reported symptoms and provider's clinical decision.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other long term (current) drug therapy
Z79.899Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Adverse effect of antihyperlipidemic and antiarteriosclerotic drugs, subsequent encounter
T46.6X5DDocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Atorvastatin Use and Adverse Effects to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code T46.6X5A.
Impact
Clinical: Misrepresents patient therapy duration., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Verify therapy duration before coding, Educate staff on correct code usage
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always sequence T46.6X5A before the primary diagnosis code when documenting adverse effects.
Impact
Inadequate documentation of adverse effects can lead to audit issues.
Mitigation Strategy
Ensure detailed documentation of symptoms and lab results.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Atorvastatin Use and Adverse Effects, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Atorvastatin Use and Adverse Effects
Use these documentation templates to ensure complete and accurate documentation for Atorvastatin Use and Adverse Effects. These templates include all required elements for proper coding and billing.
Patient experiencing atorvastatin intolerance
Specialty: CardiologyRequired Elements
- Patient symptoms
- Lab results
- Medication changes
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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