Summary & Overview
HCPCS G9441: Statin Prescribed at Discharge
HCPCS Level II code G9441 documents that a patient was prescribed a statin at hospital discharge. This measure signals attention to secondary prevention of cardiovascular disease and cholesterol management during care transitions, a nationally relevant quality and care-continuity metric. It is used in hospital and inpatient discharge workflows to capture prescribing activity tied to lipid-lowering therapy.
Key payers typically engaged with this measure include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, clinical context around statin use at discharge, and the types of benchmarks and policy considerations that commonly accompany billing and quality reporting for discharge medication reconciliation. The publication outlines expected service lines and sites of service, clarifies payer coverage landscape at a national level, and highlights common questions about coding capture and reporting for transition-of-care medication interventions.
The content does not offer clinical recommendations; it provides operational and policy-oriented context for clinicians, coders, and administrators working with discharge medication documentation and quality reporting.
Billing Code Overview
HCPCS Level II code G9441 denotes Statin prescribed at discharge. This code represents documentation that a patient was prescribed a statin medication at the time of discharge from an inpatient or observation stay. The service type is medication prescribing/transition-of-care medication management. The typical site of service is hospital discharge or other inpatient/observation discharge settings.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male admitted for acute coronary syndrome who undergoes percutaneous coronary intervention and will be discharged the same day or within 24–72 hours. At discharge the inpatient or observation provider documents medications and prescribes a high- or moderate-intensity statin to reduce recurrent atherosclerotic cardiovascular events. The clinical workflow includes medication reconciliation by the inpatient team or pharmacist, documentation of the statin prescription in the discharge summary and electronic health record, counseling on adherence and potential side effects, and transmission of the prescription to the patient’s preferred pharmacy. This billing descriptor G9441 is used to capture that a statin was prescribed at discharge as part of secondary prevention after an ischemic cardiovascular event or for primary prevention in high-risk patients.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
24 | Unrelated evaluation and management service by the same physician during a postoperative period | Use when the statin prescription is documented during an unrelated E/M encounter in a postoperative global period. |
| 25 | Significant, separately identifiable E/M service on the same day as another procedure or service | Use when a distinct E/M visit supports decision to prescribe statin at discharge separate from other procedures.