How to Improve Statin Use Quality Performance by Coding for Exclusions

Statin use is a common and weighty quality measure for many plans. Understandably, many patients cannot take statins due to intolerance or another condition. However, those cases still count against quality performance unless exclusions are coded annually.

The next time you have a patient who cannot use a statin, try one of the codes below. Only these codes are accepted. Other codes, such as Statin Intolerance or Statin Refusal will not remove the patient from the quality measure.

Reminder: Patients can be removed from statin quality measures by submitting applicable codes during visits. Generic statin intolerance codes are NOT accepted.

For more details about statin quality measures, members can access VHAN’s Provider Guide to Statin Quality Measures on the VHAN Hub Resource Library.