June 2023 Content Release Copied

06/30/20232023 ContentContent releasePhysician, Clinical, Admin, Billing

Clinical Profile Documentation

Updates

AJCC 8th Edition Staging

This release contains updates to align with the St. Jude modification of the Ann Arbor system to the Lugano Classification system for the following problem groups:

  • Lymphoma, Non-Hodgkin (NHL), Lymphoblastic
  • Lymphoma, Non-Hodgkin (NHL), Burkitt’s

The staging row will display updated Stage values based on the changes. The new content does not affect previous charting documented on existing patients. All previous charting is brought forward during a subsequent visit, just as it did prior to this release.

Lymphoma, Non-Hodgkin (NHL), Lymphoblastic and Lymphoma, Non-Hodgkin (NHL), Burkitt’s staging row will display updated Stage values based on the changes. The following documentation points have changed:

  • New Stage Values: I, IE, II, IIE, II bulky*, III, IV
  • Removed Stage Values: IIR, IIIA, IIIB

Problem Groups

Additions

Mammary invasive carcinoma is now available for Breast cancer, Histopathologic Type.

Malignant melanoma of uveal tract (disorder) has been added to Melanoma, Uvea, and Ciliary Body/Choroid problem groups.

Problems

Additions

New items are available for documentation in Problems and appear in Charge Capture Report (CCR).

Problem & Codes Summary

Problem ICD-10 Codes
Difficulty eating due to fatigue (finding) R53.83 Other fatigue

R63.30 Feeding difficulties, unspecified
Deep vein thrombosis (DVT) I82 category
Energy and stamina finding (finding) R53.83 Other fatigue
Excessive postexertional fatigue (finding) R53.83 Other fatigue
Exhausted on least exertion (finding) R53.83 Other fatigue

R54 Age-related physical debility
Exhaustion (finding) R53.83 Other fatigue
Extreme exhaustion (finding) R53.83 Other fatigue
Fatigability (finding) R53.83 Other fatigue
Fatigue with acquired immunodeficiency syndrome (disorder) B20 Human immunodeficiency virus [HIV] disease

R53.83 Other fatigue
Finding of general energy (finding) R53.83 Other fatigue

R54 Age-related physical debility
Finding of general stamina (finding) R53.83 Other fatigue
Functional quadriplegia (disorder) R53.2 Functional quadriplegia
Functional quadriplegia due to multiple sclerosis (disorder) G35 Multiple sclerosis

R53.2 Functional quadriplegia
General problem AND/OR complaint (finding) Z78.9 Other specified health status
Generally unwell (finding) R69 Illness, unspecified
Infectious disease (disorder) B99.9 Unspecified infectious disease
Screening for Lung Cancer Z12.2 – Encounter for screening for malignant neoplasm of respiratory organs
Seizure disorder (disorder) R56.9 Unspecified convulsions
Sensation of heaviness in limbs (finding) R29.898 Other symptoms and signs involving the musculoskeletal system
Tired (finding) P96.89 Other specified conditions originating in the perinatal period

R53.83 Other fatigue
Tired all the time (finding) R53.82 Other fatigue
Tired on least exertion (finding) R53.83 Other fatigue
Tires quickly (finding) R53.83 Other fatigue
Underactive infant (finding) R53.83 Other fatigue
Underexertion (finding) R53.83 Other fatigue
Weakness as late effect of stroke (disorder) I69.398 Other sequelae of cerebral infarction

R53.1 Weakness

Lab Analytes & Panels

Additions and Updates

  • 14Q32 IGH FISH nomenclature
  • Abs neut confirmed
  • AFB body site
  • AFB culture source
  • Albumin, urine, mg/TV
  • Albumin, urine timed, mg/dL
  • Albumin, urine excretion rate, mcg/min
  • APRI index
  • Auto diff confirmed
  • CALR %
  • CALR amino acid
  • CALR nucleotide
  • CALR result
  • Coproporphyrin (CP) I, ug/L
  • Coproporphyrin (CP) III, ug/L
  • del(9p) CDKN2A FISH nomenclature
  • del(9p) CDKN2A FISH interpretation
  • DPYD director review
  • DPYD genotype
  • DPYD information
  • DPYD metabolic activity
  • E12-15 result
  • E12-15 %
  • E12-15 nucleotide
  • E12-15 amino acid
  • E12-15/CALR/MPL background
  • Factor H auto Ab, Unit/mL
  • FISH, MPN/CML targetgene result
  • FISH, MPN/CML targetgene PDF
  • Heptacarboxyl (7-CP), ug/L
  • Herpesvirus 7 IgG Ab, IFA
  • Hexacarboxyl (6-CP), ug/L
  • IHC PD-L1
  • JAK2 mutation MPL, %
  • Lysosomal enzyme screen
  • MPL %
  • MPL amino acid
  • MPL nucleotide
  • MPL result
  • NGS methodology
  • NGS review
  • Paraprotein excret/24hr UPE, mg/24 hr
  • Paraprotein UPE, %
  • Pentacarboxyl (5-CP), ug/L
  • Rh(Du)
  • Slide review required
  • Tacrolimus II, ng/mL
  • Uroporphyrins (UP), ug/L
  • Volume for microscopic (ua), mL
  • Albumin timed urine panel
  • ctDNA Signatera
  • Factor H auto Ab panel
  • FISH, MPN/CML targetgene panel
  • FoundationOne PD-L1 panel
  • HHV 7 IgG Ab panel
  • Lysosomal enzyme screen panel
  • NGS JAK2 E12-15/CALR/MPL panel
  • Porphyrins, Qn, random urine panel
  • Porphobilinogen, random urine, quant panel

Medications

Additions

  • ABBV-151 invest IV
  • ART6043 invest Oral
  • ARV-471 invest Oral
  • CLR 131 invest IV
  • DS-6000a invest IV
  • Elacestrant dihydrochloride invest Oral
  • EO-3021 invest IV
  • EP0062 invest Oral
  • Livmoniplimab invest (ABBV-151 invest IV)
  • SGN-BB228 invest IV
  • Tirzepatide Sodium-Pyridoxine Hydrochloride Subcutaneous
  • XmAb662 invest IV

Updates

Medication Update
ARX788 invest IV New Form available: 10 mg/mL frozen liquid
BA3021 invest IV New Synonym available: Ozuriftamab Vedotin invest
Disitamab Vedotin (RC48-ADC) invest IV New Form available: 45 mg recon soln (set as default)
KIN-2787 invest Oral New Forms available:

  • 50 mg tablet
  • 200 mg tablet
Niacinamide Oral New Default Dose available: 500 mg
Nystatin Oral Suspension Retired Quick Sigs Instructions with “swish and spit.”
Opium Oral Tincture New Quick Sig available: 0.5 mL by mouth every 4 hours prn diarrhea
Promacta (Eltrombopag Oral) New Instructions available: Take on an empty stomach, 2 hrs before or 4 hrs after food or calcium products.

Regimen Library

Additions

Biosimilar Addition

This release contains the inclusion of a new bevacizumab biosimilar (Vegzelma) into all applicable regimen templates.

Regimen Name Problem Group
Albumin (Hypoalbuminemia) Supportive Care All Problems
BCG (TICE) (Intravesicular) Maintenance D1,8,15 Q84D fb Q168D (Part 1 of 2) Bladder Cancer, Renal Pelvis and Ureter Cancer, Urethral Cancer
BCG (TICE) (Intravesicular) Maintenance D1,8,15 Q84D fb Q168D (Part 2 of 2) Bladder Cancer, Renal Pelvis and Ureter Cancer, Urethral Cancer
Docetaxel + Oxaliplatin + Bevacizumab Q21D Fallopian Tube Cancer, Ovarian and Primary Peritoneal Cancer
Epcoritamab-bysp SQ D1,8,15,22 fb D1,15 fb D1 Q28D Lymphoma, Non-Hodgkin (NHL) (Parent)
Mirvetuximab soravtansine-gynx + Bevacizumab Q21D Fallopian Tube Cancer, Ovarian and Primary Peritoneal Cancer
Olaparib + Abiraterone + Prednisone Q30D Prostate Cancer
Pembrolizumab (Dose Banding) + Lenvatinib Q42D Melanoma, Skin, Renal Cell Carcinoma (RCC), Uterine Cancer (Parent)
Pembrolizumab Q42D (Dose Banding) (Adjuvant Breast) Breast Cancer
Pemetrexed + Carboplatin + Bevacizumab Q21D (Mesothelioma) Malignant Mesothelioma, Malignant Pleural Mesothelioma
Ribociclib D1-21 + Anastrozole Q28D (Adjuvant) Breast Cancer
Ribociclib D1-21 + Letrozole Q28D (Adjuvant) Breast Cancer

Updates

Regimens for the following diagnoses have been updated based on the Collaborative Care Committee voting. Changes include but are not limited to reference update, drug infusion instruction updates, renaming of regimens, premedication template updates and number of cycles.

  • All Problems
  • Amyloidosis
  • Brain Tumor (Parent)
  • Breast Cancer
  • Cervical Cancer
  • Colon Cancer
  • Fallopian Tube Cancer
  • Hepatocellular Carcinoma (HCC)
  • Immune Thrombocytopenia Purpura (ITP)
  • Leukemia, Chronic Lymphocytic (CLL)
  • Lung Cancer, Non-small Cell (NSCLC)

Research

Updates

  • Lymphoma, Non-Hodgkin (NHL) (Parent)
  • Malignant Mesothelioma
  • Malignant Pleural Mesothelioma
  • Ovarian and Primary Peritoneal Cancer
  • Polycythemia Vera
  • Rectal Cancer
  • Renal Cell Carcinoma (RCC)
  • Uterine Cancer (Parent)
  • Waldenstrom’s Macrogobulinemia
Updated Reference Information Updated Drug Service Order Information Updated Regimen Instructions Other Changes
USOR 20289 X X X Now available: USOR 20289 SEA-TGT + Brentuximab Vedotin Q21D
USOR 20305 X X
USOR 20307 X X
USOR 21173 X Now available:

  • USOR 21173 AZD9833 or Placebo (Daily) + Ribociclib (D1-21) + Anastrozole or Placebo (Daily) Q28D
  • USOR 21173 AZD9833 or Placebo (Daily) + Ribociclib (D1-21) + Letrozole or Placebo (Daily) Q28D
USOR 21225 X X X
USOR 21270 X X X No longer available: USOR 21270 ZN-c3 (Continuous Dosing) Q21D
USOR 21287 X X X
USOR 21507 X X X
USOR 21507 X X X
USOR 21550 X
USOR 22035 X X X
USOR 22041 X X X Now available: USOR 22041 Repriming Cycle Epcoritamab SC D1,8,15,22
USOR 22074 X X X
USOR 22147 X X X

Billing & HCPCS Codes

Please visit CMS’s website for a complete list of July 2023 HCPCS Quarterly updates.

Updates

Medication HCPCS Codes
Acetaminophen IV J0137 per 10 mg
Allopurinol IV J0206 per 1 mg
Aztreonam IV, IM, Intraperitoneal J0457 per:

  • 100 mg
  • 0.1 gm
Bendamustine IV: DOS 4/1/23-6/30/23 J9999 per 1 mg
Bendamustine IV [Apotex]: DOS 7/1/23-12/31/9999 J9058 per 1 mg
Bendamustine IV (Baxter) J9059 per 1 mg
Bendamustine IV (Vivimusta) J9056 per 1 mg
Bupivacine IV J0665 per 0.5 mg
Buprenorphine Subcutaneous ER Solution (Brixadi Monthly) Q9991 per 24 mg
Buprenorphine Subcutaneous ER Solution (Brixadi Weekly) Q9991 per 24 mg
Clindamycin IV J0736 per 300 mg
Clindamycin (Baxter) J0737 per 30 mg
Epcoritamab-bysp (Epkinly) J3590 per:

  • 8 mg
  • 48 mg
Esmolol IV J1805 per 10 mg
Esmolol IV (wg critical care) J1806 per 10 mg
Factor IX Human (Recom Thr148) IV J7213 per 1 unit
Fecal Microbiota, Live-jslm Enema J1440 per 1mL
Furosemide Subcutaneous J1941 per 20 mg
Immune globulin, Gamma (IgG)-ifas IV J1576 per 500 mg
Insulin Aspart (niacinamide) Continuous Subcutaneous Infusion (Fiasp) J1811 per 50 UNITS (For administration through dme (i.e., insulin pump))

J1812 per 5 units
Insulin Aspart (niacinamide) IV (Fiasp) J1811 per 50 UNITS (For administration through dme (i.e., insulin pump))

J1812 per 5 units
Insulin Aspart (niacinamide) Subcutaneous (Fiasp) J1811 per 50 UNITS (For administration through dme (i.e., insulin pump))

J1812 per 5 units
Insulin Aspart (niacinamide) Subcutaneous Pen (Fiasp FlexTouch) J1812 per 5 units
Insulin Aspart (niacinamide) (Lyumjev) J1813 per 50 UNITS (For administration through dme (i.e., insulin pump))

J1814 per 5 units
Insulin Lispro-aabc Subcutaneous Pen 100 unit/mL (Lyumjev Kwikpen) J1814 per 5 units
Labetalol IV J1920 per 5 mg

J1921 per 5 mg
Lendacapavir Subq J1961 per 1 mg
Metronidazole IV J1836 per 10 mg
Mirvetuximab soravtansine-gynx IV J9063 per 1 mg
Mosunetuzumab-axgb IV J9350 per 1 mg
Nitroglycerin IV J2305 per 5 mg
Paliperidone IM (3-month, 6-month) J2427 per 1 mg
Phenylephrine IV, IM, Subq J2371 per 20 mcg
Posluma (Flotufolastat F 18 Gallium) A9597 per:

  • 296 MBq
  • 8 MCi
Remimazolam IV J2249 per 1 mg
Teclistamab-cqyv Subcutaneous J9380 per 0.5 mg
Teplizumab-mzwv IV J9381 per 5 mg
Tirzepatide Subcutaneous Pen Injector (Mounjaro) J3490 per 7.5 mg
Tremelimumab-actl IV J9347 per 25 mg
Ublituximab-xiiy IV J2329 per 1 mg
Vasopressin IV (am reg) J2599 per 1 unit
Vasopressin Continuous Intra-Arterial Infusion J2598 per 1 unit
Vasopressin Endotracheal J2598 per 1 unit
Vasopressin IV J2598 per 1 unit
Vasopressin Intraosseous J2598 per 1 unit
Vasopressin IM J2598 per 1 unit
Vasopressin Subcutaneous J2598 per 1 unit

HCPCS & NDC Crosswalk

Additions

Effective July 1, 2023, unless noted by DOS.

Medication (Brand) HCPCS Code NDC
Acetaminophen (Hikam) J0137 per 10 mg 00143938601
00143938610
Bendamustine: DOS 4/1/23-6/30/23 J9999 per 1 mg 60505622800
Bendamustine (Apotex) J9058 per 1 mg 60505622800
Bendamustine (Baxter) J9059 per 1 mg 10019007901
Bendamustine (Vivimusta) J9056 per 1 mg 71225012001
Clindamycin J0736 per 300 mg 25021011502
00781328891
67457081504
00781328909
00781328991
00781329009
00009090218
72572007624
67457081402
25021011504
67457081500
63323028204
63323028206
63323028260
00009305102
25021011551
63323028202
00009509506
00009087021
72572007601
00009077526
67457081400
00009077520
67457081600
00009090211
00009407303
00009072805
72572007424
67457081606
00009509505
00009407304
00781328809
72572007401
25021011506
00009305101
00009087026
00009072809
Clindamycin (Baxter) J0737 per 300 mg 00338411450
43066099524
43066099324
00338955350
00338954524
00338955324
00338361624
00338954924
00338361250
00338411424
00338954950
00338381450
00338381424
00338361650
00338341024
00338341050
00338361224
00338954550
Esmolol (wg crit care) J1806 per 10 mg 44567081210
44567081110
Insulin Aspart (Fiasp) J1811 per 50 UNITS (For administration through dme (i.e., insulin pump))
J1812 per 5 UNITS		 00169320111
Insulin Aspart (Fiasp flex touch) J1812 per 5 UNITS 00169320515
00169320415
00169320511
Insulin Aspart (Lyumjev) J1813 per 50 units ((For administration through dme (i.e., insulin pump))

J1814 per 5 units

 00002772801
Insulin Lispro-aabc (Lyumjev KwikPen) J1814 per 5 units 00002822827
00002820701
00002820705
00002822801
00002823501
00002823505
Labetalol J1920 per 5 mg 36000032010
00143936610
72266010201
36000032001
70092100944
25021031740
70004070028
00143936601
72611073801
70092101044
70092155844
70092155944
70092200944
36000032402
00143962201
00641625201
00641625210
25021031720
72266010341
72611073401
47781058629
47781058656
65302050304
36000032401
36000032202
36000032201
69374094604
69374094634
72572035001
70004070006
00409226754
00143962301
00143932001
72266010301
00409226720
00409233934
00409233924
Labetalol (Hikma) J1921 per 5 mg 00143936510
00143936501
00143936410
00143936310
00143936301
00143936401
Metronidazole J1836 per 10 mg 47335099301
25021013182
00409781137
00409781111
00409015224
00409015201
00338954124
00338105548
00264553532
Paclitaxel-Protein Bound (American Regent):
DOS 4/1/23-6/30/23		 J9999 per 1 mg J9259 per 1 mg 00517430001
Pemetrexed J9323 per 10 mg 00409218801
00409353201
00409104501
Pemetrexed (Bluepoint) J9322 per 10 mg 68001055141
68001055041
Vasopressin (American Regent) J2599 per 1 unit 00517102001