December 2022 Content Release Copied
Clinical Profile Documentation Problems
Additions
The Problems > Add Details area is updated with applicable documentation points for the following diagnoses.
BRAF mutation is now available for Pancreatic Cancer with the following documentation points:
- BRAF V600E (Mutated)
- Wild-type
- Mutations
- Unknown
RET gene mutation is now available for Pancreatic Cancer with the following documentation points:
- RET fusion positive
- RET fusion negative
- Ordered: Result pending
- Not performed
- Unknown
New items are available for documentation in Problems and appear in the Charge Capture Report (CCR). Additional ICD-10 codes may be displayed to present the surrounding nodes.
| Problem | ICD-10 Codes |
| At high risk for breast cancer (finding) | Z91.89 Other specified personal risk factors, not elsewhere classified |
| BMI 25-29 overweight | Z68.26 Body mass index [BMI] 26.0-26.9, adult Z68.27 Body mass index [BMI] 27.0-27.9, adult Z68.28 Body mass index [BMI] 28.0-28.9, adult Z68.29 Body mass index [BMI] 29.0-29.9, adult |
| Breast lump (finding) | N63.10 Unspecified lump in the right breast, unspecified quadrant N63.11 Unspecified lump in the right breast, upper outer quadrant N63.12 Unspecified lump in the right breast, upper inner quadrant N63.13 Unspecified lump in the right breast, lower outer quadrant N63.14 Unspecified lump in the right breast, lower inner quadrant N63.15 Unspecified lump in the right breast, overlapping quadrants N63.20 Unspecified lump in the left breast, unspecified quadrant N63.21 Unspecified lump in the left breast, upper outer quadrant N63.22 Unspecified lump in the left breast, upper inner quadrant N63.23 Unspecified lump in the left breast, lower outer quadrant N63.24 Unspecified lump in the left breast, lower inner quadrant N63.25 Unspecified lump in the left breast, overlapping quadrants N63.3 Unspecified lump in axillary tail N63.31 Unspecified lump in axillary tail, of the right breast N63.32 Unspecified lump in axillary tail, of the left breast N63.41 Unspecified lump in right breast, subareolar N63.42 Unspecified lump in left breast, subareolar |
Lab, Analytes, Panels & Orders
Additions
- 6-acetylmorphine, urine (cutoff 5 ng/mL)
- Alpha globin DNA analysis panel
- Anticoagulants, urine, qual
- Antidiabetics, urine, qual
- Antihistamines, urine, qual
- pneumoniae PCR
- Cardiac, urine, qual
- Codeine, urine (cutoff 5 ng/mL)
- Cough suppressants, urine, qual
- CSF monocyte/macrophage panel
- CSF monocyte/macrophage, %
- D-dimer, mg/dL
- Dihydrocodeine, urine
- EDDP, urine
- EDDP, urine (cutoff 10 ng/mL)
- FOLR1
- Histoplasma mycelial, CF
- HLA-B
- HLA-C
- HPV genotype reflex
- HRD-GSS
- Hydrocodone, urine (cutoff 5 ng/mL)
- Hydromorphone, urine (cutoff 5 ng/mL)
- Invitae antithrombin III deficiency test panel
- Invitae antithrombin III deficiency test result
- Lining cells, body fluid
- Meperidine, urine (cutoff 10 ng/mL)
- Methadone, urine (cutoff 10 ng/mL)
- Methamphetamines D+L, urine, ng/mL
- Morphine, urine (cutoff 5 ng/mL)
- Muscle relaxants, urine, qual
- Naloxone, urine (cutoff 10 ng/mL)
- N-Desmethyltapentadol, urine (cutoff 5 ng/mL)
- Norbuprenorphine, urine (cutoff 5 ng/mL)
- Norfentanyl, urine (cutoff 5 ng/mL)
- Normeperidine, urine
- NSAIDS, urine, qual
- O-desmethyl-CIS-tramadol, urine (cutoff 100 ng/dL)
- Opioids, urine, qual
- Oxycodone, urine (cutoff 5 ng/mL)
- Oxymorphone, urine (cutoff 5 ng/mL)
- Sedative-hypnotics, urine, qual
- Tapentadol, urine (cutoff 5 ng/mL)
- Tramadol, urine (cutoff 10 ng/mL)
- Zinc protoporphyrin
- (ZPP), whole blood
Updates
- CT chest low dose w/o contrast has been updated to CT chest low dose radiation w/o contrast
Medications
Additions
- 212-PB-Dotamate invest IV
- ABBV-319 invest IV
- Gedatolisib invest IV
- Rejuvaskin Skin Recovery Cream
Updates
| Medication | Update |
| Elahere (mirvetuximab soravtansine-gynx) | J3590 per 100 mg |
| Impact Advanced Recovery Oral Liquid | NDC now available:
|
| Impact Advanced Recovery Oral Liquid | Dispensable form now available:
|
| Tzield (teplizumab-mzwv) | J3590 per 2 mg |
Regimen Library
This section does not contain clinical trial regimens.
Additions
| Regimen Name | Diagnosis |
| Abraxane D1,15 + Gemcitabine D1,15 Q28D (Modified) | Pancreatic Cancer |
| Cemiplimab-rwlc + Paclitaxel + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Cemiplimab-rwlc + Paclitaxel + Cisplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Cemiplimab-rwlc + Pemetrexed + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Cemiplimab-rwlc + Pemetrexed + Cisplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Cobimetinib D1-21 Q28D (Histiocytic Neoplasms) | Hematologic Malignancies (Parent); Histiocytosis |
| Fluorouracil (Bolus + CIV) D1-2 + Leucovorin + Oxaliplatin (FOLFOX 6, Modified) + Cetuximab Q14D | Colon Cancer; Rectal Cancer |
| Mirvetuximab soravtansine-gynx Q21D | Fallopian Tube Cancer; Ovarian and Primary Peritoneal Cancer |
| Nivolumab + Cetuximab Q14D | Head and Neck Cancer (Parent) |
| Nivolumab + Gemcitabine D1,8 + Carboplatin Q21D (Neoadjuvant NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Nivolumab + Pemetrexed + Carboplatin Q21D (Neoadjuvant NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Pembrolizumab + Docetaxel + Carboplatin Q21D (Part 1 of 2) | Head and Neck Cancer (Parent) |
| Topotecan IV D1-5 Q21D (Uterine) | Uterine Cancer (Parent) |
| Tremelimumab-actl + Durvalumab + Pemetrexed + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab + Pemetrexed + Cisplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab + Gemcitabine D1,8 + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab + Gemcitabine D1,8 + Cisplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab + Abraxane D1,8,15 + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab Q28D Maintenance | Lung Cancer, Non-small Cell (NSCLC) |
| Tremelimumab-actl + Durvalumab + Pemetrexed Q28D Maintenance | Lung Cancer, Non-small Cell (NSCLC) |
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
- Brain Tumor (Parent)
- Breast Cancer
- Cervical Cancer
- Leukemia, Acute Lymphocytic (ALL)
- Leukemia, Chronic Lymphocytic (CLL)
Renames
- Lymphoma, Non-Hodgkin (NHL) (Parent)
- Melanoma, Skin
- Multiple Myeloma (MM)
- Polycythemia Vera
- Uterine Cancer (Parent)
| Previous Name | New Name |
| Temozolomide IV D1-42 + XRT Q42D fb Temozolomide IV D1-5 Q28D (Part 1 of 2: Temozolomide IV + XRT Only) | Temozolomide IV D1-42 + XRT Q42D fb Temozolomide IV D1-5 Q28D (Part 1 of 2) |
| Temozolomide PO D1-42 + XRT Q42D fb Temozolomide PO D1-5 Q28D (Part 1 of 2: Temozolomide PO + XRT) | Temozolomide PO D1-42 + XRT Q42D fb Temozolomide PO D1-5 Q28D (Part 1 of 2) |
Research
Updates
| Updated Reference Information | Updated Drug Service Order Information | Updated Regimen Instructions | Other Changes | |
| USOR 19105 | X | X | ||
| USOR 20137 | X | |||
| USOR 20223 | X | X | ||
| USOR 20418 | X | |||
| USOR 21239 | X | X | X | Now available:
USOR 21239 Arm A Pemetrexed + Carboplatin + Amivantamab (if less than 80 kg) Cycles 1-4 No longer available: USOR 21239 Arm A Lazertinib (PO; Daily) + Pemetrexed + Carboplatin + Amivantamab (if less than 80 kg) Cycles 1-4 USOR 21239 Arm A Lazertinib (PO; Daily) + Pemetrexed + Carboplatin + Amivantamab (if 80 kg or greater) Cycles 1-4 |
| USOR 21309 | X | X | X | Now available:
USOR 21309 Carboplatin + Upifitamab Rilsodotin Q28D (Cycle 1-6) USOR 21309 Upifitamab Rilsodotin Maintenance Q28D (Cycle 7+) No longer available: USOR 21309 Module A Carboplatin + Upifitamab Rilsodotin Q28D (Cycle 1-6) |
| USOR 21527 | X | X | X | |
| USOR 22018 | X | X | X | |
| USOR 22052 | X | |||
| USOR 22074 | X | X | ||
| USOR 22147 | X | X | X |
Billing & HCPCS Codes
The January 2023 updates include new HCPCS Level II codes to separately identify products approved under the 505(b)(2) New Drug Application (NDA) or the Biologics License Applications (BLA) pathways after October 2003, and not rated as therapeutically equivalent to a reference listed product in an existing code. A complete application summary and coding link can be found here.
As of the December content release, all HCPCS Level II are not available from our vendors for updating. We anticipate all codes being fully updated in iKnowMed by Thursday, Jan. 5, 2023.
Updates
Please visit the CMS website for a complete list of January 2023 HCPCS Quarterly updates.
| Medication | HCPCS Codes |
| Acetaminophen (B Braun), not therapeutically equivalent to J0131 | J0134 per 10 mg |
| Acetaminophen (Fresenius), not therapeutically equivalent to J0131 | J0134 per 10 mg |
| Argatroban (Accord), not therapeutically equivalent to J0883 (for non- esrd use) | J0891 per 1 mg |
| Argatroban (Auromedics), not therapeutically equivalent to J0883 (for non-esrd use) | J0898 per 1 mg |
| Amiodarone HCl (Nexterone) | J0823 per 30 mg |
| Bortezomib, (Dr. Reddy’s), not therapeutically equivalent to J9041 | J9046 per 0.1 mg |
| Bortezomib (Fresenius Kabi), not therapeutically equivalent to J9041 | J9048 per 0.1 mg |
| Bortezomib (Hospira), not therapeutically equivalent to J9041 | J9049 per 0.1 mg |
| Calcium gluconate (Wg critical care) | J0611 per 10 mL |
| Cefazolin sodium (Baxter), not therapeutically equivalent to J0690 | J0689 per 500 mg |
| Cefepime HCL (Baxter), not therapeutically equivalent to Maxipime | J0701 per 500 mg |
| Cefepime HCL (B Braun), not therapeutically equivalent to Maxipime | J0703 per 500 mg |
| Chloroprocaine Hydrochloride | J2401 per 1 mg |
| Chloroprocaine Hydrochloride (Clorotekal) | J2402 per 1 mg |
| Daptomycin (Hospira), not therapeutically equivalent to J0878 | J0877 per 1 mg |
| Decitabine (Sun Pharma), not therapeutically equivalent to J0894 | J0893 per 1 mg |
| Epinephrine (Belcher), not therapeutically equivalent to J0171 | J0173 per 0.1 mg |
| Fosaprepitant (Teva), not therapeutically equivalent to J1453 | J1456 per 1 mg |
| Fulvestrant (Fresenius Kabi) not therapeutically equivalent to J9395 | J9394 per 25 mg |
| Fulvestrant (Teva) not therapeutically equivalent to J9395 | J9393 per 25 mg |
| Ganciclovir sodium (Excela), not therapeutically equivalent to J1570 | J1574 per 500 mg |
| Glucagon Hydrochloride (Fresenius Kabi), not therapeutically equivalent to J1610 | J1611 per 1 mg |
| Heparin sodium (Pfizer), not therapeutically equivalent to J1644 | J1643 per 1000 units |
| Leuprolide Acetate (Lutrate) | J1954 per 7.5 mg |
| Linezolid (Hospira), not therapeutically equivalent to J2020 | J2021 per 200 mg |
| Meropenem (B Braun), not therapeutically equivalent to J2185 | J2184 per 100 mg |
| Micafungin sodium (Par Phar), not therapeutically equivalent to J2248 | J2247 per 1 mg |
| Midazolam Hydrochloride (Wg critical care), not therapeutically equivalent to J2250 | J2251 per 1 mg |
| Morphine Sulfate (Fresenius Kabi), not therapeutically equivalent to J2270 | J2272 up to 10 mg |
| Moxifloxacin (Fresenius Kabi), not therapeutically equivalent to J2280 | J2281 per 100 mg |
| Naloxone Hydrochloride (Zimhi) | J2311 per 1 mg |
| Pemetrexed IV (Teva) not therapeutically equivalent to J9305 | J9314 10 mg |
| Risankizumab-rzaa | J2327 per 1 mg |
| Tecovirimat (Tpoxx) | 90622 per
|
| Tigecycline (Accord), not therapeutically equivalent to J3243 | J3244 per 1 mg |
| Trace Elements Zn-Cu-Mn-Se IV 3 mg-0.3 mg-55 mcg-60 mcg/mL | J3490 per 1 mL |
| Vancomycin HCL (Mylan), not therapeutically equivalent to J3370 | J3371 per 500 mg |
| Vancomycin HCL (Xellia), not therapeutically equivalent to J3370 | J3372 per 500 mg |
| Vutrisiran | J0225 per 1 mg |