ICD-10 Guide

Statin Intolerance

ICD-10 Coding for Statin Intolerance(Z79.899, Z91.130, G72.0)

PRIMARY SPECIALTYCardiology

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Statin Intolerance?

Essential facts and insights about Statin Intolerance

Key Clinical Considerations:

Muscle pain or weakness after starting statin therapy
Elevated creatine kinase (CK) levels
Resolution of symptoms upon discontinuation of statin

Clinical Information

Clinical Criteria & Documentation Requirements

Patient history of statin use and adverse reactions
Details of muscle symptoms and timing relative to statin initiation
Results of laboratory tests including CK levels

Coding Guidelines

Usage Guidelines & Examples

Follow usage guidelines for coding statin intolerance versus other lipid disorders.
Common errors include misclassifying statin intolerance as myopathy without proper documentation.

Code Exclusions

Important Exclusions

Myopathy due to non-statin medications
Alternative codes for muscle disorders unrelated to statin use

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

Patients with a history of cardiovascular disease or high cholesterol
Cardiology clinics and primary care settings

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

Comprehensive clinical documentation
Accurate code selection based on clinical criteria
Proper exclusion considerations
Specialty-specific coding guidelines

Documentation

Documentation Templates

Billing Information

Billing Considerations

Ensure proper documentation for billing
Verify code specificity requirements
Check for any additional codes needed
Review payer-specific guidelines

Common Issues

Insufficient clinical documentation
Incorrect code selection
Missing supporting diagnoses
Timing and frequency documentation

Frequently Asked Questions

What are the documentation requirements?

Document patient history, symptoms, and lab results.

What are the billing considerations?

Ensure accurate coding to reflect statin intolerance for reimbursement.

Statin Intolerance

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?

Statin Intolerance

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What are the documentation requirements?

What are the billing considerations?