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    v1.0.30
    OpenPayerBilling CodesTherapeutic, Preventive or Other InterventionsCPT cpt-4013f-statin-therapy-prescription-or-current-use
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    CPT 4013F: Statin Therapy Prescription or Current Use

    CPT code 4013F reports that a provider prescribes or the patient is currently taking statin therapy, a lipid‑lowering medication used to reduce cholesterol production in the liver; this code documents statin use as part of ongoing medication management and is typically captured during office or outpatient visits where cardiovascular risk and lipid management are assessed.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with a history of hyperlipidemia and coronary artery disease presents to primary care for routine chronic disease management. The clinician reviews recent fasting lipid panel results showing elevated LDL cholesterol despite current therapy. The provider documents initiation or continuation of statin therapy, adjusts dose based on efficacy and tolerability, reviews potential drug interactions and adverse effects, and issues a prescription or refill for a statin. Typical workflow includes medication reconciliation, assessment of adherence and side effects, review of labs (lipid panel, liver function tests as indicated), patient counseling, and electronic prescribing. Typical site of service is an outpatient clinic or primary care office; care may also be provided in a cardiology clinic or chronic care management visit.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for evaluation and management of an established patient, typically 15 minutesCommon visit code for follow-up where statin prescription is issued or adjusted.
    80061Lipid panel (cholesterol, HDL, LDL, triglycerides)Lab test commonly ordered to monitor response to statin therapy.
    84460Assay of electrochemiluminescence testosterone — (not applicable)Data not available in the input.
    96372Therapeutic, prophylactic, or diagnostic injection (specify substance)Occasionally used if parenteral lipid-lowering agents or injections are administered in clinic.
    G0444Annual depression screening, 15 minutesScreening that may co-occur during chronic care visits; not directly related but often performed in primary care.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    1PModifier 1P is a Category II performance measure exclusion modifier used to indicate that a patient’s medical condition prevented performance of the action specified by a Category II quality measure…- Use modifier 1P only with Category II (quality reporting) codes when the specific measure’s reporting instructions explicitly allow a medical-reason exclusion; it marks the patient as medically…
    92Modifier 92 (Alternative Laboratory Platform Testing) is used when laboratory tests are performed with single‑use, disposable, portable kits or transportable instruments. The AMA defines it for tests…- Use modifier 92 when a laboratory test is performed using a single‑use, disposable analytical device or kit (an alternative laboratory platform) that is portable and may be taken to or near the…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207R00000X
    207RG0300X
    363A00000X
    363L00000X
    2083B0002X
    281PC2000X
    207QG0300X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E03.9Hypothyroidism, unspecified
    E11.22Type 2 diabetes mellitus with diabetic chronic kidney disease
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E11.65Type 2 diabetes mellitus with hyperglycemia
    E66.9Obesity, unspecified
    E78.00Pure hypercholesterolemia, unspecified
    E78.1Pure hyperglyceridemia
    E78.2Mixed hyperlipidemia
    E78.5Hyperlipidemia, unspecified
    E78.6Lipoprotein deficiency

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    CPT-4000F-ASTHMA-TOBACCO-EXPOSURE-COUNSELING

    CPT 4000F: Asthma-Related Tobacco Exposure and Counseling

    CPT-4001F-ASTHMA-TOBACCO-EXPOSURE-SMOKING-CESSATION-MEDICATION-DISCUSSION

    CPT 4001F: Asthma Patient Tobacco Exposure and Smoking Cessation Discussion

    CPT-4003F-UNDEFINED-MEASURE

    CPT 4003F: Preventive Counseling or Risk-Factor Intervention

    CPT-4004F-TOBACCO-USE-SCREENING-AND-CESSATION-OFFER-ADULT

    CPT 4004F: Tobacco Use Screening and Offer of Cessation for Adults

    CPT-4005F-UNKNOWN-SERVICE

    CPT 4005F: No Summary found

    CPT-4008F-UNKNOWN-SERVICE

    CPT 4008F: No Summary available

    CPT-4010F-ACE-INHIBITOR-ARB-THERAPY-DOCUMENTATION

    CPT 4010F: ACE Inhibitor or ARB Therapy Prescribed or Current

    CPT-4011F-ANTIPLATELET-THERAPY-PRESCRIPTION-MANAGEMENT

    CPT 4011F: Prescription for Antiplatelet Therapy

    CPT-4012F-UNCATEGORIZED-PROCEDURE

    CPT 4012F: No Summary Available

    CPT-4014F-PERFORMANCE-MEASURE-QUALITY-REPORTING

    CPT 4014F: Unspecified Procedure — No Summary Available

    Showing 1–10 of 175

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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