July 2021 Content Release Copied

07/29/20212021 ContentContent releasePhysician, Clinical, Admin, Billing

Clinical Profile: Problems

The following items are available for documentation in Problems and appear on the Charge Capture Report (CCR). *Additional ICD10 codes may display to present the surrounding nodes.

Problem ICD10 Code Choice(s)*
Anemia in chronic kidney disease D63.1 – Anemia in chronic kidney disease
Anemia in chronic kidney disease (CKD) D63.1 – Anemia in chronic kidney disease
Chronic kidney disease stage 1 (GFR > 90) N18.1 – Chronic kidney disease, stage 1
Chronic kidney disease stage 2 (GFR 60-89) N18.2 – Chronic kidney disease, stage 2 (mild)
Chronic kidney disease stage 4 (GFR 15-29) N18.4 – Chronic kidney disease, stage 4 (severe)
Chronic kidney disease stage 5 (GFR < 15) N18.5 – Chronic kidney disease, stage 5
Screening for malignant neoplasm of colon done Z12.11 – Encounter for screening for malignant neoplasm of colon

Lab Analyte & Panel Additions and Other Services

Additions

  • COVID-19 antibody S interpretation
  • COVID-19 antibody, U/mL
  • CPSF6
  • Human placental lactogen
  • Human placental lactogen panel
  • JAK2 exon 12 mutation assay details
  • JAK2 exon 12 mutation interpretation
  • JAK2 exon 12 mutation specimen source
  • Legionella antigen urine panel
  • NAB2
  • NR1D1
  • Pap smear SurePath IM reflex to HPV high risk if ASCUS panel
  • PAP smear, SurePath IM CPT
  • PAP smear, SurePath IM cytotechnologist
  • PAP smear, SurePath IM interpretation
  • PAP smear, SurePath IM LMP
  • PAP smear, SurePath IM location
  • PAP smear, SurePath IM slides
  • PAP smear, SurePath IM source
  • PAP smear, SurePath IM specimen adequacy
  • PSA post prostatectomy panel
  • PSA, ICMA, ng/mL
  • SARS CoV-2 semi-quantitative total Ab, U/mL
  • SARS-CoV-2 spike Ab interpretation
  • SurePath IM reflex to HPV high risk if ASCUS
  • Thyroglobulin ab, Beckman Coulter
  • Thyroglobulin, Beckman Coulter ICMA
  • TMEM87B
  • Tysabri(R) Ab comments
  • Tysabri(R) Ab interpretation
  • Tysabri(R) Ab methods
  • Tysabri(R) Ab panel
  • Tysabri(R) Ab references
  • Tysabri(R) Ab technical result

Other Services

  • Copper cu-64, dotatate, diagnostic, 1 millicurie
  • Fluoroestradiol F18, diagnostic, 1 mCi
  • PET/CT scan Cu-64 Detectnet (Dotatate)
  • PET/CT scan F-18 Cerianna (fluoroestradiol)
  • PET/CT scan F-18 Pylarify (PSMA)
Procedure CPT code
CT low dose whole body 76497
Fat pad biopsy 15838

Medications

Additions

  • Capecitabine invest Oral
  • KHK2455 invest Oral
  • MDMA HCl Oral
  • Misoprostol 0.0024% Mouthwash (Lidocaine-Misoprostol)
  • Oregovomab invest IV
  • PCS6422 invest Oral
  • TPX-0046 invest Oral

Updates

Drug Changes
Avelumab invest IV Added Sig: 800 mg intravenously every 2 weeks
BTCT4465A invest Subcutaneous Added Forms:

  • 5 mg/0.5 mL Subcutaneous
  • 45 mg/1 mL Subcutaneous
CTX-471 invest IV Added Units:

  • 0.3 mg/kg
  • 0.6 mg/kg
PF-06821497 invest Oral Added Form: 250 mg Tablet

Financial Approval Required Updates

On certain drugs, Financial Approval Required was not checked, which caused an Insurance Authorization issue. To avoid the issue for the drugs below, Financial Approval Required is now checked.

  • Abatacept IV
  • Abatacept Subcutaneous
  • Abatacept Subcutaneous Auto-Injector
  • Acai Berry Oral Liquid
  • Acetazolamide IV
  • Acetylcysteine IV
  • Acyclovir IV
  • Adalimumab Subcutaneous
  • Adalimumab Subcutaneous Pen Injector Kit 80 mg/0.8 mL- 40 mg/0.4 mL
  • Adalimumab Subcutaneous Starter Pack 80 mg/0.8 mL-40 mg/0.4 mL
  • Adenosine IV
  • Alemtuzumab IV 12 mg/1.2 mL
  • Alemtuzumab Subcutaneous
  • Alprostadil IV
  • Alteplase IV
  • Amikacin IV
  • Aminophylline IV
  • Amobarbital IV
  • Amphotericin B IV
  • Amphotericin B Liposome IV
  • Ampicillin IV
  • Amplimexon IV
  • Angiotensin II IV
  • Anidulafungin IV
  • Antihemophilic Factor (Human) IV
  • Anti-Thymocyte Glob (Rabbit) IV
  • Anti-thymocyte Immunoglobulin IV
  • Atropine IV
  • Azathioprine IV
  • Azithromycin IV
  • Bamlanivimab IV (1 of 2) (EUA)
  • Basiliximab IV
  • Belimumab IV
  • Belimumab Subcutaneous
  • Belimumab Subcutaneous Auto-injector
  • Benfotiamine Oral
  • Bevacizumab Intravitreal
  • Bevacizumab IV
  • Bevacizumab-awwb IV
  • Bevacizumab-bvzr IV
  • Bezlotoxumab IV
  • Bicalutamide invest Oral
  • Bivalirudin IV
  • Blinatumomab IV
  • Brexanolone IV
  • Brodalumab Subcutaneous
  • Bumetanide IV
  • Burosumab-twza Subcutaneous
  • C1 Esterase Inhibitor (PF) IV (Cinryze)
  • Caffeine Citrated IV
  • Carfilzomib invest IV
  • Casirivimab (REGN10933) Subcutaneous (1 of 2) (EUA)
  • Casirivimab-Imdevimab Subcutaneous Dose Pack 120 mg/mL-120 mg/mL (EUA)
  • Cefazolin IM
  • Cefazolin Intraperitoneal
  • Cefazolin Irrigation
  • Cefazolin IV
  • Cefazolin Topical
  • Cefepime IM
  • Cefepime IV
  • Cefotaxime IM
  • Cefotaxime Intraperitoneal
  • Cefotetan IV
  • Cefoxitin IV
  • Ceftazidime IV
  • Ceftriaxone IM
  • Ceftriaxone IV
  • Cefuroxime IM
  • Cefuroxime IV
  • Certolizumab Pegol Subcutaneous
  • Cetuximab IV
  • Chloramphenicol IV
  • Chlorothiazide IV
  • Chlorpromazine IM
  • Chlorpromazine IV
  • Cidofovir IV
  • Ciprofloxacin IV
  • Clindamycin IV
  • Coagulation Factor IX IV
  • Coagulation Factor VIIa IV
  • Colistimethate IV
  • Conjugated Estrogens IV
  • Corticorelin Ovine Triflutate IV
  • Cosyntropin IM
  • Cosyntropin IV
  • Cosyntropin Subcutaneous
  • CPI-1205 invest Oral
  • Crizanlizumab-tmca IV
  • Crotalidae Polyval Immune Fab IV
  • Cyclosporine IV
  • Dantrolene IV
  • DCDS0780A invest IV
  • Denosumab Subcutaneous (120 mg/1.7 mL – Xgeva)
  • Denosumab Subcutaneous (60 mg/mL – Prolia)
  • Desmopressin IM
  • Desmopressin IV
  • Desmopressin Subcutaneous
  • Dexamethasone IV
  • Dextrose 5 % In Ringers IV
  • Diazepam IV
  • Digoxin IV
  • Dimenhydrinate IV
  • Dimercaprol IM
  • Diphenhydramine IV
  • Diphon Mouth Rinse Mouthwash
  • Dipyridamole IV
  • Dobutamine IV
  • Dopamine IV
  • Doxercalciferol IV
  • Droperidol IV
  • Eculizumab IV
  • Elosulfase Alfa IV
  • Emapalumab-lzsg IV
  • Emicizumab-kxwh Subcutaneous
  • EPA/DHA essentials Oral
  • Epinephrine (PF) IV
  • Epoetin beta, Methoxy PEG IV
  • Epoprostenol IV (Arginine)
  • Eptinezumab-jjmr IV
  • Erenumab-aooe Subcutaneous Auto-Injector
  • Ertapenem IV
  • Erythromycin IV
  • Estradiol Cypionate IM
  • Etanercept Subcutaneous Pen Injector
  • Etesevimab IV (2 of 2) (EUA)
  • Ethanolamine IV
  • Factor IX Complex IV
  • Famotidine (PF) IV
  • Fluciclovine F 18 IV
  • Fluconazole IV
  • Flumazenil IV
  • Fluocinolone Intravitreal 0.59 mg
  • Folic Acid IM
  • Follitropin Alfa Subcutaneous
  • Follitropin Beta Subcutaneous
  • Fomepizole IV
  • Foscarnet IV
  • Fremanezumab-vfrm Subcutaneous
  • Fremanezumab-vfrm Subcutaneous Auto-Injector
  • Furosemide IV
  • Gadobenate Dimeglumine IV
  • Gadobutrol IV
  • Gadodiamide IV
  • Gadoteridol IV
  • Gadoxetate IV
  • Galcanezumab-gnlm Subcutaneous
  • Galcanezumab-gnlm Subcutaneous Pen Injector
  • Galsulfase IV
  • Gentamicin (PF) IV
  • Glucagon IV
  • Golimumab IV
  • Golimumab Subcutaneous
  • Granisetron (PF) IV
  • Grapiprant (ARY-007) invest Oral
  • Guselkumab Subcutaneous
  • Guselkumab Subcutaneous Auto-Injector
  • Haloperidol IV
  • Hydralazine IV
  • Hydrocortisone (PF) IV
  • Hydrocortisone IV
  • Hydromorphone (Carpuject) IV
  • Hydromorphone (PF) Epidural
  • Hydromorphone (PF) IM
  • Hydromorphone (PF) Intrathecal
  • Hydromorphone (PF) IV
  • Hydromorphone (PF) Subcutaneous
  • Hydromorphone IM
  • Hydromorphone IV
  • Hydromorphone Oral
  • Hydromorphone Oral 24 hr Tab
  • Hydromorphone Oral Liquid
  • Hydromorphone Subcutaneous
  • Hydroxocobalamin IM
  • Hydroxocobalamin IV
  • Hyoscyamine IV
  • Ibalizumab-uiyk IV
  • Ibandronate IV
  • Ibutilide IV
  • Idarucizumab IV
  • Idursulfase IV
  • Imdevimab (REGN10987) Subcutaneous (2 of 2) (EUA)
  • Imiglucerase IV
  • Imipenem-Cilastatin (1:1) Intraperitoneal
  • Imipenem-Cilastatin (1:1) IV
  • Imipenem-Cilastatin- Relebactam IV
  • Imm glob G (IgG)-Sorb-IgA 0- 50 (PF) IV
  • Immun glob G (IgG)-Gly-IgA 0- 50 (PF) IV
  • Immun Glob G (IgG)-Gly-IgA 50+ (PF) IV
  • Immun Glob G (IgG)-Gly-IgA 50+ (PF) Subcutaneous
  • Immun glob G(IgG)-Malt-IgA 50+ (PF) IV
  • Immun glob G(IgG)-Pro-IgA 0- 50 (PF) IV
  • Immun glob G-Gly-Gluc-IgA 0- 50 (PF) IV ( IgA <1 ug/mL)
  • Immune globulin, Gamma(IgG)-hipp Subcutaneous
  • INCB039110 invest Oral SR
  • IncobotulinumtoxinA IM
  • IncobotulinumtoxinA Intrasalivary gland
  • Indigotindisulfonate IV
  • Indocyanine Green IV
  • Indomethacin IV
  • Infliximab IV
  • Infliximab-abda IV
  • Infliximab-axxq IV
  • Infliximab-dyyb IV
  • Insulin Aspart Continuous Subcutaneous Infusion
  • Insulin Aspart IV
  • Insulin Pen Needle
  • Insulin Regular Human IV
  • Interferon Alfa-n3 Intralesional
  • Interferon Beta-1a IM
  • Interferon Beta-1a Subcutaneous
  • Interferon Beta-1a Subcutaneous Pen Injector
  • Interferon Gamma-1B Subcutaneous
  • Iobenguane Sulfate I-123 IV
  • Iodixanol IV 270 mg iodine/mL
  • Iodixanol IV 320 mg iodine/mL
  • Iohexol Intra-Arterial 140 mg iodine/mL
  • Iohexol Intra-Arterial 300 mg iodine/mL
  • Iohexol Intra-Arterial 350 mg iodine/mL
  • Iohexol Intrasynovial 300 mg iodine/mL
  • Iohexol Intrathecal 180 mg iodine/mL
  • Iohexol Intrathecal 300 mg iodine/mL
  • Iohexol Intrauterine 300 mg iodine/mL
  • Iohexol Intraventricular 350 mg iodine/mL
  • Iohexol Intravesical 100 mg iodine/mL
  • Iohexol Intravesical 240 mg iodine/mL
  • Iohexol Intravesical 50 mg iodine/mL
  • Iohexol Intravesical 60 mg iodine/mL
  • Iohexol Intravesical 70 mg iodine/mL
  • Iohexol Intravesical 80 mg iodine/mL
  • Iohexol Intravesical 90 mg iodine/mL
  • Iohexol IV 240 mg iodine/mL
  • Iohexol IV 300 mg iodine/mL
  • Iohexol IV 350 mg iodine/mL
  • Iopamidol Intra-Arterial 76 %
  • Iopamidol Intra-Articular
  • Iopamidol Intrathecal 41 %
  • Iopamidol Intrathecal 61 %
  • Iopamidol IV 41 %
  • Iopamidol IV 51 %
  • Iopamidol IV 61 %
  • Iopamidol IV 76 %
  • Iopromide Intra-Arterial 62 %
  • Iopromide Intra-Arterial 77 %
  • Iopromide IV 50 %
  • Iopromide IV 62 %
  • Iopromide IV 77 %
  • Iothalamate Meglumine Intra- Arterial 30 %
  • Iothalamate Meglumine Intra- Arterial 43 %
  • Iothalamate Meglumine Intra- Arterial 60 %
  • Iothalamate Meglumine Intraductal 60 %
  • Iothalamate Meglumine Intrasynovial 60 %
  • Iothalamate Meglumine IV 30%
  • Iothalamate Meglumine IV 43%
  • Iothalamate Meglumine IV 60%
  • Iothalamate Meglumine Urethral
  • Ioversol Intra-Arterial 300 mg iodine/mL
  • Ioversol Intra-Arterial 320 mg iodine/mL
  • Ioversol Intra-Arterial 350 mg iodine/mL
  • Ioversol IV 300 mg iodine/mL
  • Ioversol IV 320 mg iodine/mL
  • Ioversol IV 350 mg iodine/mL
  • Ioxilan Intra-Arterial 350 mg/mL
  • Iron Carbon, Gluc-FA-B12-C- DSS Oral 90 mg-1 mg-12 mcg- 50 mg
  • Iron-FA-B12-C-Docusat Sodium Oral 90 mg-1 mg-12 mcg-120 mg-50mg
  • Isavuconazonium sulfate IV
  • Isoproterenol IV
  • Ixekizumab Subcutaneous
  • Ixekizumab Subcutaneous Auto-Injector
  • Ketamine IV
  • Ketorolac IV
  • Kit for Prep of Ga 68-Dotatate IV
  • Kit for Prep Tc-99m-Bicisate IV
  • Kit for Tc 99m–Labeled RBCs IV
  • Kit for Tc 99m–Mertiatide (betiat) IV
  • Kit for Tc 99m-Sestamibi No.1 IV
  • Kit for Tc-99m-Tilmanocept Intradermal
  • Kit for Tc-99m-Tilmanocept Subcutaneous
  • Kit Prep of Tc-99m- Tetrofosmin IV
  • Kit Prep Tc 99m-Sod Oxidronate IV
  • Labetalol IV
  • Laronidase IV
  • LEE011 invest Oral
  • Lefamulin IV
  • Letermovir IV
  • Levetiracetam IV
  • Levocarnitine IV
  • Levofloxacin IV
  • Levothyroxine IM
  • Levothyroxine IV
  • Lidocaine (PF) IV
  • Lidocaine IV
  • Lidocaine-Nifedipine Kit 3 %-0.5 %
  • Lincomycin IV
  • Linezolid IV
  • Liothyronine IV
  • Lorazepam IV
  • Loteprednol Ophthalmic Gel 0.5 %
  • Magic Mouthwash (Lidocaine- Benadryl-Maalox-Nystatin)
  • Magnesium Chloride IV
  • Magnesium Sulfate in D5W IV
  • Magnesium Sulfate in NS IV
  • Magnesium Sulfate IV
  • Manganese Chloride IV
  • Mannitol IV 10 %
  • Mannitol IV 15 %
  • Mannitol IV 20 %
  • Mannitol IV 25 %
  • Mannitol IV 5 %
  • Menotropins Subcutaneous
  • Meperidine (PF) IM
  • Meperidine (PF) IV
  • Meperidine IV
  • Mepolizumab Subcutaneous
  • Mepolizumab Subcutaneous Auto-Injector
  • Meropenem IV
  • Meropenem-Vaborbactam IV 2 gram
  • Methadone IV
  • Methocarbamol IM
  • Methocarbamol IV
  • Methohexital IM
  • Methohexital IV
  • Methyldopa IV
  • Methylene Blue IV
  • Methylergonovine IV
  • Methylprednisolone Intra- Articular
  • Metoclopramide IV
  • Metoprolol IV
  • Metreleptin Subcutaneous
  • Metronidazole IV
  • Micafungin IV
  • Midazolam (PF) IV
  • Midazolam IV
  • Milrinone IV
  • Minocycline IV
  • MLN9708 invest Oral
  • Morphine (PF) IM
  • Morphine (PF) Intrathecal
  • Morphine (PF) IV
  • Morphine (PF) Subcutaneous
  • Morphine IM
  • Morphine IM Pen Injector
  • Morphine IV
  • Morphine Topical Gel 1%
  • Moxifloxacin IV
  • MVI, Adult No.1 With Vit K IV
  • MVI, Adult No.2 without Vit K IV
  • MVI, Adult No.4 with Vit K (Component Vial 1 of 2) IV 3,300 unit-150 mcg/5 mL
  • MVI, Adult No.4 with Vit K (Component Vial 2 of 2) IV 600 mcg-60 mcg-5 mcg/5 mL
  • MVI, Adult No.4 with Vit K IV 3,300 unit-150 mcg/10 mL
  • MVI, Pedi No.1 With Vit K IV 80 mg-400 unit-200 mcg/5 mL
  • MVI, Pedi No.2 With Vit K IV 80 mg-400 unit-200 mcg
  • Mycophenolate IV
  • Na Chondroit Sulf-Na Hyaluron Intraocular
  • Na Ferric Gluc Cplx in Sucrose IV
  • Nafcillin IV
  • Nalbuphine IV
  • Naloxone IV
  • NC318 invest IV
  • Neostigmine IV
  • Nerve Cream Topical (Elavil 4%, Gabapentin 6%, Baclofen 4%, Diclofenac 4%)
  • odium nitrite-Sodium thiosulfate IV 300 mg/10 mL- 12.5 gram/50 mL
  • Olanzapine IV
  • Omalizumab Subcutaneous
  • Ondansetron (PF) IV
  • Ondansetron Oral
  • Oritavancin IV
  • Orphenadrine IV
  • Oxacillin IV
  • Oxytocin IM
  • Oxytocin IV
  • Palifermin IV
  • Paliperidone IM (3-month)
  • Paliperidone IM (monthly)
  • Palivizumab IM
  • Palivizumab IV
  • Pancuronium IV
  • Papaverine IV
  • Parathyroid Hormone Subcutaneous
  • Paricalcitol IV
  • Pasireotide Subcutaneous
  • Peginterferon beta-1a IM
  • Pegvaliase-pqpz Subcutaneous
  • Pegvisomant Subcutaneous
  • Penicillin G Sodium IV
  • Pentobarbital IV
  • Peramivir (PF) IV
  • Pertuzumab IV
  • Phenobarbital IV
  • Phentolamine IV
  • Phenylephrine IV
  • Phenytoin IM
  • Phenytoin IV
  • Physostigmine IV
  • Phytonadione IV (Vitamin K1)
  • Piflufolastat F 18 IV
  • Piperacillin-Tazobactam (8:1) IV
  • Plasma Protein Fraction IV 5 %
  • Pneumococcal 13-Val Conj-Dip Crm (PF) IM
  • Pneumococcal 23-ValPS Vaccine IM
  • Pneumococcal 23-ValPS Vaccine Subcutaneous
  • Polidocanol IV Solution
  • Poliovirus Vaccine (IPV) IM
  • Poliovirus Vaccine (IPV) Subcutaneous
  • Polymyxin B IV
  • Posaconazole IV
  • Potassium Acetate IV
  • Potassium Chloride IV
  • Potassium Phosphate IV
  • Pralidoxime IV
  • Procainamide IV
  • Prochlorperazine IM
  • Prochlorperazine IV
  • Promethazine IM
  • Promethazine IV
  • Propofol (PF) IV
  • Propranolol IV
  • Protamine IV
  • Protein C Concentrate, Human IV
  • Pyridostigmine IM
  • Pyridostigmine IV
  • Pyridoxine IV
  • Quinupristin-Dalfopristin (3:7) IV
  • Racemethionine Oral
  • Regadenoson IV
  • Remdesivir IV
  • Remdesivir IV (pts 40 kg or more)
  • Remifentanil IV
  • Remimazolam IV
  • Reslizumab IV
  • Reteplase IV
  • Rho D Immune Globulin IV
  • Rho D Immune Globulin- Maltose IM
  • Rho D Immune Globulin- Maltose IV
  • Rifampin IV
  • Rocuronium IV
  • Rolapitant IV
  • Ropivacaine (PF) Continuous Infiltration 0.5 %
  • Ropivacaine (PF) Intraspinal 0.5 %
  • Ropivacaine (PF) Subcutaneous 0.75 %
  • Sarilumab Subcutaneous
  • Sarilumab Subcutaneous Pen Injector
  • Sebelipase alfa IV
  • Secretin IV
  • Secukinumab Subcutaneous
  • Secukinumab Subcutaneous Pen Injector
  • Selenium IV
  • Sildenafil IV
  • Sincalide IV
  • Sirolimus Oral
  • Sodium Acetate IV
  • Sodium Tetradecyl Sulfate IV 1%
  • Sodium Tetradecyl Sulfate IV 3%
  • Sodium Thiosulfate IV
  • Sorbitol-Mannitol Urethral
  • Sotalol IV
  • Streptomycin IV
  • Study Drug Investigational Intradermal [antineoplastic]
  • Succinylcholine IV
  • Sufentanil Epidural
  • Sufentanil Intrathecal
  • Sufentanil IV
  • Sugammadex IV
  • Sym004 invest IV
  • Taurine Oral
  • Tedizolid IV
  • Telavancin IV
  • Tenecteplase IV
  • Terbutaline IV
  • Teriparatide Subcutaneous
  • Teriparatide Subcutaneous Pen Injector
  • Tesamorelin Subcutaneous
  • Testosterone Cypionate IM
  • Testosterone Enanthate IM
  • Testosterone Undecanoate IM
  • Theophylline IV
  • Thiamine IV
  • Tigecycline IV
  • Tildrakizumab-asmn Subcutaneous
  • Tirofiban IV
  • Tirofiban IV 250 mcg/mL (bolus dose concentrate)
  • Tobramycin IV
  • Tocilizumab Subcutaneous Pen Injector
  • Topical for Chemo Induced Post Herpetic Neuralgia
  • Trabectedin IV
  • Tranexamic Acid IV
  • Treprostinil IV
  • Tromethamine IV
  • Typhoid VI Polysacch Vaccine IM
  • Vancomycin IV
  • Varicella Virus Vaccine Live (PF) Subcutaneous (Varivax)
  • Varicella-Zoster Glycop E Vaccine (Component Vial 2 of 2) IM
  • Varicella-Zoster Immune Glob IM
  • Vasopressin Continuous Intra- Arterial Infusion
  • Vasopressin IM
  • Vasopressin Intraosseous
  • Vasopressin Subcutaneous
  • Vecuronium IV
  • Velaglucerase alfa IV
  • Verapamil IV
  • Verteporfin IV
  • Vestronidase alfa-vjbk IV
  • von Willebrand Factor (Recomb) IV
  • Voriconazole IV
  • White Faced Hornet Venom Intradermal
  • Yellow Fever Vaccine (PF) IM
  • Yellow Fever Vaccine (PF) Subcutaneous
  • Zinc Chloride IV
  • Zinc Sulfate IV
  • Ziprasidone IM
  • Zoster Vaccine Live (PF) Subcutaneous

Regimens

This section does not include clinical trials.

Based on Collaborative Care Committee (CCC) decision and vote, last month regimens classified as low emetic risk were updated to pre-check Granisetron, IV [1000 mcg] based on NCCN Guideline recommendations. Over the next several months, applicable regimen templates containing low emetic risk premedications schedules in higher emetic risk regimens will be updated, accordingly.

Additions

The following regimens are now available for ordering in the Regimen Library.

Regimen Diagnoses
Aducanumab-avwa Q28D All Problems
Avapritinib Q30D (Systemic Mastocytosis) Myeloproliferative Disorder
Fluorouracil (Bolus + CIV) D1-2 + Leucovorin + Irinotecan (FOLFIRI) + Trastuzumab IV BIOSIMILAR Q14D Esophageal Cancer (Parent); Gastric Cancer
Fluorouracil (Bolus + CIV) D1-2 + Leucovorin + Irinotecan (FOLFIRI) + Trastuzumab IV Q14D Esophageal Cancer (Parent); Gastric Cancer
Fluorouracil (Bolus + CIV) D1-2 + Leucovorin + Oxaliplatin (FOLFOX 6, Modified) (Q14D) + Trastuzumab IV + Pembrolizumab (Q21D) Q42D Esophageal Cancer (Parent); Gastric Cancer
Fluorouracil (Bolus + CIV) D1-2 + Leucovorin + Oxaliplatin (FOLFOX 6, Modified) (Q14D) + Trastuzumab IV BIOSIMILAR + Pembrolizumab (Q21D) Q42D Esophageal Cancer (Parent); Gastric Cancer
Fluorouracil CIV D1-33 + Oxaliplatin D1,15,29 + XRT Q35D Esophageal Cancer (Parent); Gastric 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.

  • Breast Cancer
  • Esophageal Cancer (Parent)
  • Fallopian Tube Cancer
  • Gastric Cancer
  • Gastrointestinal Stromal Tumor (Parent)
  • Lung Cancer, Non-small Cell (NSCLC)
  • Lymphoma, Hodgkin (HL)
  • Lymphoma, Non-Hodgkin (NHL) (Parent)
  • Lymphoma, Non-Hodgkin (NHL), Primary Cutaneous
  • Melanoma, Skin
  • Myeloproliferative Disorder
  • Ovarian and Primary Peritoneal Cancer
  • Primary Cutaneous Lymphoma, Mycosis Fungoides/Sezary Syndrome
  • Sarcoma, Soft Tissue (Parent)

Renames

Previous Name New Name
Avapritinib Q30D Avapritinib Q30D (GIST)
Carboplatin + Paclitaxel D1,8,15 Dose Dense Q21D (Ovarian) Paclitaxel D1,8,15 + Carboplatin Q21D (Dose Dense, Ovarian)
Dactinomycin D1 Q14D Dactinomycin Q14D
Nivolumab Q14D (Flat Dose, Adjuvant Melanoma) Nivolumab Q14D (Flat Dose) (Adjuvant Melanoma, Esophageal)
Nivolumab Q14D (Dose Banding, Adjuvant Melanoma) Nivolumab Q14D (Dose Banding) (Adjuvant Melanoma, Esophageal)
Nivolumab Q28D (Dose Banding, Adjuvant Melanoma) Nivolumab Q28D (Dose Banding) (Adjuvant Melanoma, Esophageal)
Nivolumab Q28D (Flat Dose, Adjuvant Melanoma) Nivolumab Q28D (Flat Dose) (Adjuvant Melanoma, Esophageal)
Lenalidomide D1-21 + Rituximab IV BIOSIMILAR Cycle 1 D1,8,15,22 fb Cycles 4,6,8,10,12 D1 Q28D Lenalidomide D1-21 + Rituximab IV C1 D1,8,15,22 fb C4,6,8,10,12 Q28D (Part 1 of 2: Induction)
Lenalidomide D1-21 + Rituximab IV BIOSIMILAR Cycle 1 D1,8,15,22 Q28D Lenalidomide D1-21 + Rituximab IV BIOSIMILAR C1 D1,8,15,22 fb C4,6,8,10,12 Q28D (Part 1 of 2: Induction)
Lenalidomide D1-21 + Rituximab IV Cycle 1 D1,8,15,22 fb Cycles 4,6,8,10,12 D1 Q28D Lenalidomide D1-21 + Rituximab IV BIOSIMILAR C1 D1,8,15,22 Q28D
Lenalidomide D1-21 + Rituximab IV Cycle 1 D1,8,15,22 Q28D Lenalidomide D1-21 + Rituximab IV C1 D1,8,15,22 Q28D

Research Regimen Updates

The USOR Clinical Trials listed in the table below have been updated.

Updated Reference Information Updated Drug Service Order Information Updated Regimen Instructions Other Changes
USOR 18119 The following regimen is now available for ordering:

USOR 18119 Part E Nivolumab SQ Coformulated with rHuPH20 D1,15 Q28D

The following regimens are no longer available for ordering: USOR 18119 Part C Crossover Nivolumab SQ + rHuPH20 SQ USOR 18119 Part D Nivolumab SQ + rHuPH20 SQ
USOR 18187 X
USOR 19024 X
USOR 19109 X The following regimens are no longer available for ordering: USOR 19109 PF-06821497

USOR 19109 PF-06821497 + Etoposide + Cisplatin USOR 19109 PF-06821497 + Etoposide + Carboplatin
USOR 19122 X X
USOR 20176 X X
USOR 19191 X X
USOR 20214 X X X
USOR 20223 X
USOR 20289 X X
USOR 20354 X X
USOR 20382 X
USOR 20383 X
USOR 20398 X X
USOR 20412 X

Billing: HCPCS Codes

Medication HCPCS Code
Etonogestrel Subdermal Implant J7307 per 1 Implant
Gallium Ga-68 Gozetotide IV 18.5 MBq to 185 MBq/mL A9593 per 1 mCi
Palivizumab IM 90378 per 50 mg
Palivizumab IV 90378 per 50 mg
Peginterferon beta-1a IM J3490 per 125 mcg
Risankizumab-rzaa Subcutaneous Pen Injector J3590 per 150 mg