Wiki ICD-10-CM for Statin Intolerance

[Cardio403]

We have been having a debate about which 7th digit should use with code: T46.6X5- when a patient has know intolerance to statin medication.

ex: Pt. came into the office 2 years ago and was found to be intolerant to this medication class. Patient came into office for routine follow up of CAD, HTN & Hyperlipidemia. MD mentions "know history of statin intolerance"

Would we use the "A". Others suggest to use the "S" because it was previously known.

The guidelines are not very clear on this, or I am just not seeing it.

Thanks for your advise on this.

 

[thomas7331]

The T46.6X5- codes would not be correct for this situation - those codes would be used if your provider was treating the patient for the adverse effects of the drug (A or D) or for the sequela of that event (S), i.e. any enduring aftereffects. Per the notes above, this is part of the patient's history that may influence treatment, but is not an active condition requiring treatment.

Patient history is not routinely coded to ICD-10 unless one of the conditions being treated has a 'use additional code' note instructing you to do so, but if you need to report it, ICD-10 would direct you to Z91.89 - Other specified personal risk factors, not elsewhere classified (history, personal, poisoning NEC), or potentially to Z88.8 - Allergy status to other drugs, medicaments and biological substances status (if the documentation supports that the intolerance was due to an allergy).