February 2023 Content Release Copied
Clinical Profile Documentation
AJCC 8th Edition Staging
This release contains updated TNM values, Staging Groups, and Template functionality to align with AJCC staging conditions for:
- Melanoma, Skin
- Pancreatic Cancer
Users will see updated values and descriptions for Primary Tumor Type (T), Regional Lymph Nodes (N), and Distance Metastasis (M), documentation points.
The following documentation points are now available for Pancreatic cancer:
- T value: T1
The following documentation points are now available for Melanoma, Skin:
- T values: T1, T3, T4
- N values: N1, N2, N3
- M values: cM1a(0), cM1a(1), cM1b(0), cM1b(1), cM1c(0), cM1c(1), cM1d(0), cM1d(1),pM1a(0), pM1a(1), pM1b(0), pM1b(1), pM1c(0), pM1c(1), pM1d(0), pM1d(1)
The following documentation points now have updated descriptions for Melanoma, Skin:
- N1c, N2c, N3c
- cM1a, cM1b, cM1c, cM1d, pM1a, pM1b, pM1c, pM1d
The staging calculator will display updated Stage values based on the changes to the staging groups. 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.
Problem Groups
Additions
The Problems > Add Details service row is updated with applicable documentation points for the following diagnoses:
BRAF mutation is now available for Esophageal and Gastric cancers with the following documentation points:
- BRAF V600E (Mutated)
- Wild-type
- Mutations
- Unknown
RET gene mutation is now available for Breast, Esophageal, and Gastric cancers with the following documentation points:
- RET fusion positive
- RET fusion negative
- Ordered: Result pending
- Not performed
- Unknown
Updates
Treatment status documentation points have been updated for Fallopian Tube, Ovarian and Primary Peritoneal cancers:
- Added Platinum-refractory (PD, SD)
- Removed Platinum-resistant (PD, SD)
Problems
Additions
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.
Please see APPENDIX A for a complete summary of changes.
Lab Analytes & Panels
Additions
- Additional results
- Additional results panel
- Ambry +RNAinsight panel
- ATP6AP1
- ATP6AP2
- C11orf95
- CLDN18
- DACH1
- DGCR8
- ER/PR computer morphometric adequate for analysis
- ER/PR computer morphometric clinical data
- ER/PR computer morphometric controls
- ER/PR computer morphometric duration of fixation
- ER/PR computer morphometric fixative
- ER/PR computer morphometric interpretation
- ER/PR computer morphometric panel
- ER/PR computer morphometric pathologist
- ER/PR computer morphometric site
- ER/PR computer morphometric specimen received
- ER/PR computer morphometric technologist
- ER/PR computer morphometric time to fixation
- FOXR2
- Heparin, low molecular wt, anti-Xa panel
- Heparin, low molecular wt, anti-Xa U/mL
- HLA-A 02:01, A-1 NMDP
- HLA-A 02:01, A-2 NMDP
- Invitae protein C deficiency test panel
- Invitae protein C deficiency test result
- KBTBD4
- Ki67
- Ki67 panel
- MDH2
- Methemoglobin, venous
- MPN Mini profile panel (Jak2 V617F, Exon 12, MPL, CALR)
- NeoTYPE lymphoid disorders profile
- NYNRIN
- PD-L1 (22c3)
- PD-L1 (22c3) panel
- PRDM6
- PRKD1
- REST
- Tempus xT DPYD panel
- TRIM28
- VGB L/MIN, venous
Medications
Additions
- BGB11417 invest Oral BGB-3245 invest Oral
- BI 907828 invest Oral
- Furmonertinib invest Oral
- KSQ-4270 invest Oral
- KT-253 invest IV
- MDK-703 invest IM
- STX-478 invest Oral
- XL092 invest Oral
Updates
| Medication Name | Update |
| AGEN1181 invest IV | New Alias and Forms: Botensilimab (AGEN1181 invest IV):
|
| Balstilimab invest (AGEN2034 invest IV) | New Form: 240 mg solution |
| BMS-986213 or Nivolumab invest IV | New Name: BMS-986213 invest IV
New Alias: Nivolumab-Relatlimab invest IV |
| Brukinsa (Zanubrutinib Oral) | New Instructions: Take with or without food.
New default Sig:160 mg tablet 2 tablet orally every 12 hours; quantity sufficient for 30 days |
| GRT-C901 invest IM | New quick Sigs:
|
| IMP7068 invest Oral | New Form: 40 mg tablet |
| Jaypirca (Pirtobrutinib Oral) | New Instructions: Take with or without food. New default Sig: 200 mg orally daily; quantity sufficient for 30 days. Take with or without food. Max single Dose: 200 mg |
| Oserdu (Elacestrant Oral) | New Instructions: Take with food.
New default Sig: 345 mg orally daily; quantity sufficient for 30 days. Take with food. Max single dose: 345 mg |
| Tukysa (Tucatinib Oral) | New Instructions: Take with or without food.
New default Sig:150 mg tablet 2 tablet orally every 12 hours; quantity sufficient for 30 days |
| Lutetium Lu 177 Dotatate IV 10 mCi/mL 370 mBq/mL) | New quick Sig: 200 mCi intravenously Piggyback once |
Regimen Library
Updates to G-CSF Template
Based on recent Collaborative Care Committee discussion and vote, updates have been made to regimens containing Granulocyte colony-stimulating factor (G-CSF) and Ifosfamide.
To streamline G-CSF options, filgrastim has been removed from templates containing pre-checked pegfilgrastim. Regimens will contain filgrastim if the duration between chemotherapy doses is less than 12 days, stem cell mobilization, or Myelodysplastic Syndrome (MDS).
The following medications have been added to applicable G-CSF regimen templates:
- Fylnetra (Pegfilgrastim-pbbk Subcutaneous)
- Releuko (Filgrastim-ayow Subcutaneous)
- Stimufend (Pegfilgrastim-fpgk Subcutaneous)
Ifosfamide Infusion Length
To standardize infusion length and reduce risk for toxicity the ifosfamide bolus infusion length has been updated to 3 hours across all regimens.
Additions
| Regimen Name | Diagnosis |
| Carfilzomib D1,2,8,9,15,16 + Bendamustine D1,8 + Dexamethasone Q28D (Part 1 of 2) | Multiple Myeloma (MM) |
| Carfilzomib D1,2,8,9,15,16 + Bendamustine D1,8 + Dexamethasone Q28D (Part 2 of 2: Carfilzomib Continuation) | Multiple Myeloma (MM) |
| Dasatinib Q30D (Melanoma) | Melanoma, Skin; Melanoma, Mucosal, Head and Neck |
| Elacestrant Q30D | Breast Cancer |
| Nilotinib Q28D (Melanoma) | Melanoma, Skin; Melanoma, Mucosal, Head and Neck |
| Paclitaxel Q14D fb Doxorubicin + Cyclophosphamide (AC) Q14D Dose Dense | Breast Cancer |
| Pembrolizumab + Dabrafenib + Trametinib Q21D | Melanoma, Skin |
| Pembrolizumab + Docetaxel + Cisplatin Q21D (Part 1 of 2) | Head and Neck Cancer (Parent) |
| Pirtobrutinib Q30D | Lymphoma, Non-Hodgkin (NHL) (Parent) |
| Tucatinib + Trastuzumab IV Q21D | Colon Cancer; Rectal 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.
- Bladder Cancer
- Breast Cancer
- Cervical Cancer
- Fallopian Tube Cancer
- Gestational Trophoblastic Tumor
- Head and Neck Cancer (Parent)
- Leukemia, Acute Lymphocytic (ALL)
- Leukemia, Chronic Lymphocytic (CLL)
- Lung Cancer, Small Cell (SCLC)
- Lymphoma, Hodgkin (HL)
- Lymphoma, Non-Hodgkin (NHL) (Parent)
Research
Updates
- Melanoma, Skin
- Multiple Myeloma (MM)
- Ovarian and Primary Peritoneal Cancer
- Prostate Cancer
- Renal Pelvis and Ureter Cancer
- Sarcoma, Bone (Parent)
- Sarcoma, Soft Tissue (Parent)
- Urethral Cancer
- Uterine Cancer (Parent)
- Waldenstrom’s Macroglobulinemia
| Updated Reference Information | Updated Drug Service Order Information | Updated Regimen Instructions | Other Changes | |
| USOR 18263 | X | |||
| USOR 19105 | X | |||
| X | X | Now available:
No longer available:
|
||
| USOR 20270 | X | X | X | Now available:
|
| USOR 20306 | X | |||
| USOR 20307 | X | |||
| USOR 20310 | X | X | X | |
| USOR 20318 | X | X | X | |
| USOR 20386 | X | |||
| USOR 20423 | No longer available:
|
|||
| USOR 21219 | X | X | X | |
| USOR 21239 | X | X | Now available:
|
|
| USOR 21308 | No longer available:
Now available:
|
|||
| USOR 22107 | X | X | ||
| USOR 22174 | X | X | X | Now available:
|
Billing & HCPCS Codes
Updates
| Medication | HCPCS Codes |
| Adalimumab-atto Subcutaneous Auto-Injector | J3590 per 40 mg |
| Adalimumab-atto Subcutaneous | J3590 per:
|
| Lecanemab-irmb IV | J3590 per:
|
| Leuprolide IM (3 month) (Lutrate) | J1954 per 7.5 mg |
| Terlipressin IV (Terlivaz IV) | J3490 per 0.84 mg |
| Tezepelumab-ekko Subcutaneous Pen Injector | J2356 per 1 mg |
| Vutrisiran Subcutaneous | J0225 Vutrisiran Subcutaneous, 1 mg |
Appendix A
Problem & Codes Summary
Additions
| Problem | ICD-10 Codes |
| Acute arthritis (disorder) | M08.90 Juvenile arthritis, unspecified, unspecified site M13.80 Other specified arthritis, unspecified site |
| Acute arthropathy (disorder) | M08.90 Juvenile arthritis, unspecified, unspecified site M12.9 Arthropathy, unspecified |
| Acute disease of musculoskeletal system (disorder) | M79.9 Soft tissue disorder, unspecified |
| Acute rheumatic fever (disorder) | I00 Rheumatic fever without heart involvement |
| Acute rheumatic fever with acute arthritis (disorder) | M08.00 Unspecified juvenile rheumatoid arthritis of unspecified site |
| Ankle joint inflamed (finding) | M08.079 Unspecified juvenile rheumatoid arthritis, unspecified ankle, and foot M12.9 Arthropathy, unspecified M19.90 Unspecified osteoarthritis, unspecified site |
| Anomaly of eye (disorder) | H57.09 Other anomalies of pupillary function |
| Anti-citrullinated protein antibody positive erosive rheumatoid arthritis (disorder) | M08.00 Unspecified juvenile rheumatoid arthritis of unspecified site |
| Antiphospholipid syndrome | D68.61 Antiphospholipid syndrome |
| Arthritis of bilateral feet (disorder) | M13.871 Other specified arthritis, right ankle, and foot M13.872 Other specified arthritis, left ankle and foot M13.879 Other specified arthritis, unspecified ankle, and foot |
| Arthritis of bilateral temporomandibular joints (disorder) | M26.643 Arthritis of bilateral temporomandibular joint M26.653 Arthropathy of bilateral temporomandibular joint |
| Arthritis of elbow (disorder) | M13.821 Other specified arthritis, right elbow M13.822 Other specified arthritis, left elbow M13.829 Other specified arthritis, unspecified elbow |
| Arthritis of joint of toe (disorder) | M19.071 Primary osteoarthritis, right ankle and foot M19.072 Primary osteoarthritis, left ankle and foot |
| Arthritis of knee (disorder) | M13.861 Other specified arthritis, right knee M13.862 Other specified arthritis, left knee M13.869 Other specified arthritis, unspecified knee |
| Arthritis of left foot (disorder) | M08.072 Unspecified juvenile rheumatoid arthritis, left ankle and foot M13.872 Other specified arthritis, left ankle and foot |
| Arthritis of left glenohumeral joint (disorder) | M08.912 Juvenile arthritis, unspecified, left shoulder M13.812 Other specified arthritis, left shoulder |
| Finding of white blood cell number (finding) | D72.828 Other elevated white blood cell count D72.829 Elevated white blood cell count, unspecified D72.89 Other specified disorders of white blood cells D72.9 Disorder of white blood cells, unspecified |
| Iron deficiency without anemia (disorder) | E61.1 Iron deficiency |
| Personal history of in-situ neoplasm of other and unspecified genital organs | Z86.002 Personal history of in-situ neoplasm of other and unspecified genital organs |
| Rheumatoid arthritis | M06.9 Rheumatoid arthritis, unspecified M08.00 Unspecified juvenile rheumatoid arthritis of unspecified site |
| Rheumatoid arthritis of right foot (disorder) | M05.871 Other rheumatoid arthritis with rheumatoid factor of right ankle and foot M06.071 Rheumatoid arthritis without rheumatoid factor, right ankle, and foot M06.871 Other specified rheumatoid arthritis, right ankle, and foot M06.879 Other specified rheumatoid arthritis, unspecified ankle, and foot M08.071 Unspecified juvenile rheumatoid arthritis, right ankle, and foot |