May 2023 Content Release Copied
Clinical Profile Documentation
AJCC 8th Edition Staging
This release contains updates to align with the Cotswold modification of the Ann Arbor system to the Lugano Classification system for the following problem groups:
- Lymphoma, Hodgkin (HL)
- Lymphoma, Non-Hodgkin (NHL), Diffuse Large B-Cell
- Lymphoma, Non-Hodgkin (NHL), Mantle Cell
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), Diffuse Large B-Cell and Lymphoma, Non-Hodgkin (NHL), Mantle Cell 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: IA, IAE, IAX, IAEX, IB, IBE, IBX, IBEX, IIA, IIAE, IIAX, IIAEX, IIB, IIBE, IIBX, IIBEX, IIIA, IIIAE, IIIAX, IIIAEX, IIIB, IIIBE, IIIBX, IIIBEX, IVA, IVAX, IVB, IVBX
Lymphoma, Hodgkin (HL) staging row will display updated Stage values based on the changes. The following documentation points have changed:
- New Stage Values: II bulky*
- Removed Stage Values: IIIAE; IIIAE,S; IIIAS; IIIBE; IIIBE,S; IIIBS
Problem Groups
Additions
The Problems > Add Details area is updated with applicable documentation points for the following diagnoses.
HER-2/neu status is now available for Bile Duct and Gallbladder cancers with the following documentation points:
- Positive
- Negative
- Unknown
HER-2/neu Value-ISH is now available for Bile Duct and Gallbladder cancers with the following documentation points:
- Positive
- Negative
- Unknown
HER-2/neu Value-IHC is now available for Bile Duct and Gallbladder cancers with the following documentation points:
- 0
- 1+
- 2+
- 3+
- Unknown
Problems
Updates
Waldenstrom’s Macroglobulinemia has been assigned a pathway (PW) designation to ensure documentation remains synonymous with clinical decision support and ICD-10 mapping.
The following problems now have PW to the left of the problem in the search results:
- Waldenstrom macroglobulinemia (disorder)
Lab Analytes & Panels
Additions
- Anticardiolipin Ab, IgG, IgM, quant panel
- Anticardiolipin Ab, IgG, quant
- Anticardiolipin Ab, IgM, quant
- BK virus DNA PCR quant panel, urine
- BK virus DNA PCR quant, urine, IU/mL
- BK virus DNA PCR specimen source
- BK virus DNA PCR viral copies
- BK virus DNA, quant PCR panel
- BK virus DNA, quant PCR, plasma, IU/mL
- pneumoniae PCR
- pneumoniae PCR panel
- CLDN18
- CLDN18 panel
- CLL Mutation Analysis Amendment Result
- CLL SEQ mutational analysis panel
- Exome CNA panel, additional genes
- Exome CNA panel, clinical genes
- Exome CND panel, clinical genes
- Exome CND panel, hybrid, clinical genes
- Exome panel, additional genes
- Exome panel, clinical genes
- Exome panel, hybrid, clinical genes
- Fibrinogen activity panel
- Fibrinogen antigen/functional ratio
- HLA B-1
- HLA B-1 NMDP
- HLA B-2 NMDP
- HLA class II comment 1
- HLA class II comment 2
- HLA class II serotyping
- HLA DQA1-1 NMDP
- HLA DQA1-2 NMDP
- HLA DQB1-1 equivalent
- HLA DQB1-1 NMDP
- HLA DQB1-2 equivalent
- HLA DQB1-2 NMDP
- HLA DRB1-1 equivalent
- HLA DRB1-1 NMDP
- HLA DRB1-2 equivalent
- HLA DRB1-2 NMDP
- HLA test method
- HLA-DQB1 result 1
- HLA-DQB1 result 2
- HLA-DRB1 result 1
- HLA-DRB1 result 2
- HLA-DRB3 result 1
- HLA-DRB3 result 2
- HLA-DRB4 result 1
- HLA-DRB4 result 2
- HLA-DRB5 result 1
- HLA-DRB5 result 2
- Luteinizing hormone panel
- Luteinizing hormone, IU/L
- Meropenem, quant
- Meropenem, ug/mL
- Shiga toxin 1, PCR
- Shiga toxin 2, PCR
- Stool/GI PCR panel
- Syphilis Ab, IgG, IgM panel
- Syphilis Ab, IgG, IgM serum, qual
- Varicella DNA PCR log
- Varicella source
- Varicella zoster virus DNA, RT-PCR, quant
- Varicella zoster virus quantitative PCR panel
- Varicella zoster virus, quant, PCR
Medications
Additions
- AC699 invest Oral
- Disitamab Vedotin (RC48-ADC) invest IV
- Hydrocodone Compound Oral
- Lerociclib invest Oral
- NGM707 invest IV
Updates
| Medication | Update |
| Bevacizumab-adcd IV | Maximum single dose added: 2,250 mg
Rounding rule added: 10 mg Therapeutic category: Immunotherapy to Antineoplastic New default Sig: 5 mg/kg intravenously Piggyback once New Instructions: Dilute with NS to a total volume of 100 mL. First infusion over 90 minutes. If first infusion is tolerated, administer second infusion over 60 minutes. If second infusion is tolerated, subsequent infusions may be administered over 30 minutes. Do not mix or administer with dextrose solution. NOTE: This is Vegzelma. |
| Filgrastim-sndz Subcutaneous | Maximum single dose added: 1500 mcg |
| Mecbotamab Vedotin invest (BA3011 invest IV) | New synonym: Mecbotamab Vedotin inves |
| NUV-868 invest Oral | New dispensable form: 40 mg capsule |
| Prexasertib invest IV | New medication name: ACR-368 invest IV
New synonym: ACR-368 invest IV (Prexasertib invest) New dispensable form: 67 mg recon soln |
Regimen Library
Dexamethasone Premedication Update for Paclitaxel-containing Regimens
To improve ease of ordering and administering IV dexamethasone for patients who are non- adherent to oral dexamethasone, a pre-checked order for as needed IV dexamethasone was added to all paclitaxel-containing regimens.
Additions
| Regimen Name | Diagnosis |
| Anagrelide Q30D (Essential Thrombocythemia) | Essential Thrombocythemia |
| Docetaxel + Carboplatin (AUC 6) + Bevacizumab (15 mg/kg) Q21D (Ovarian) | Ovarian and Primary Peritoneal Cancer; Fallopian Tube Cancer |
| Dostarlimab-gxly + Paclitaxel + Carboplatin Q21D | Uterine Cancer (Parent) |
| Epirubicin + Cyclophosphamide (EC) Q21D (Neoadjuvant/Adjuvant Breast) | Breast Cancer |
| Ibrutinib + Rituximab IV Maintenance Q56D | Lymphoma, Non-Hodgkin (NHL) (Parent) |
| Rituximab IV + CHOP + Ibrutinib Q21D alternating with Rituximab IV + DHAP (Cisplatin) Q21D | Lymphoma, Non-Hodgkin (NHL) (Parent) |
| Rituximab IV + DHAP (Cisplatin) Q21D fb Rituximab IV + CHOP Q21D | Lymphoma, Non-Hodgkin (NHL) (Parent) |
| Ruxolitinib Q30D (Essential Thrombocythemia) | Essential Thrombocythemia |
Updates
Regimens for the following diagnoses have been updated based on the Collaborative Care Committee voting. Changes include but are not limited to reference updates, drug infusion instruction updates, renaming of regimens, premedication template updates and number of cycles.
- Bladder Cancer
- Breast Cancer
- Cervical Cancer
- Fallopian Tube Cancer
- Gestational Trophoblastic Tumor
- Head and Neck Cancer (Parent)
- Ovarian and Primary Peritoneal Cancer
- Penile Cancer
- Renal Pelvis and Ureter Cancer
- Urethral Cancer
- Uterine Cancer (Parent)
Research
Updates
| Updated Reference Information | Updated Drug Service Order Information | Updated Regimen Instructions | Other Changes | |
| USOR 19105 | X | |||
| USOR 20139 | X | X | ||
| USOR 20248 | X | |||
| USOR 20336 | X | |||
| USOR 20417 | X | X | X | |
| USOR 21253 | X | X | X | |
| USOR 21309 | X | X | X | |
| USOR 21386 | X | X | X | |
| USOR 21462 | X | X | X | |
| USOR 22015 | X | X | X | No longer available: USOR 22015 Stage I Crofelemer or Placebo (12 Weeks) |
| USOR 22073 | X | X | ||
| USOR 22101 | X | X | ||
| USOR 22107 | X | |||
| USOR 22141 | X | X | USOR 22166 | X | X | X | Now available: USOR 22166 Enzalutamide Monotherapy Q28D |
| USOR 22200 | X |
Billing & HCPCS Codes
Updates
| Medication | HCPCS Codes |
| Aripiprazole IM ER Susp (Abilify Asimtufii) | J0401 per 1 mg |
| Bupivacaine Intra-Articular 0.5 % | J3490 per 50 mg |
| Bupivacaine Intra-Articular 0.25 % | J3490 per 50 mg |
| Bupivacaine (PF) Intra-Articular 0.5 % | J3490 per 50 mg |
| Bupivacaine (PF) Intra-Articular 0.25 % | J3490 per 50 mg |
| Leuprolide IM (pediatric 6 month) | J1950 per 3.75 mg |
| Measles, Mumps, Rub, Varicella (PF) IM | 90710 per 0.5 mL |
| Pegfilgrastim-cbqv Subcutaneous Auto-Injector | Q5111 per 0.5 mg |
| Risperidone Subcutaneous Extended Release Susp (Uzedy) | J3490 per 125 mg |
| Tofersen Intrathecal | J3490 per 100mg |
| Varicella Virus Vaccine Live (PF) IM (Varivax) | 90716 per 0.5 mL |