November 2023 Content Release Copied

11/30/20232023 ContentContent releasePhysician, Clinical, Admin, Billing

Problem Groups

Additions

The Problems > Add Details area updated with applicable documentation points for the following diagnoses.

HER-2/neu Status is now available for Cervical Cancer with the following documentation points:

  • Positive
  • Negative
  • Unknown

HER-2/neu Value-IHC is now available for Cervical Cancer with the following documentation points:

  • 0
  • 1+
  • 2+
  • 3+
  • Unknown

HER-2/neu Value-ISH is now available for Cervical Cancer with the following documentation points:

  • Positive
  • Negative
  • Unknown

IDH1 gene mutation is now available for Myelodysplastic Syndrome (MDS) with the following documentation points:

  • Detected
  • Not detected
  • Unknown
  • Not tested

KRAS gene is now available for Colon, Pancreatic, and Rectal Cancer with the following documentation points:

  • KRAS G12C activating mutation
  • Other KRAS mutation
  • Wild-type
  • Unknown

Available for documentation within Prostate Cancer:

  • Prolaris Score
  • PSMA PET
  • Decipher Score
    • Low: 0.0 – < 0.45
  • Intermediate: 45 – < 0.60
  • High: 0.60 – 0

Problems

Additions

New items are available for documentation in Problems and appear in the Charge Capture Report (CCR). Additional ICD-10 codes may display to present the surrounding nodes.

Please see the table below for a complete summary of changes.

Problem ICD-10 Codes
At high risk for breast cancer Z91.89 – other specified personal risk factors, not elsewhere classified

Lab Analytes & Panels

Additions

  • Acetone, urine, mg/dL
  • Beta-glucosidase, leukocytes interpretation
  • Beta-glucosidase, leukocytes reviewed by
  • Beta-glucosidase, leukocytes, nmol/hr/mg prot
  • CBC w/man diff, w/reflex panel
  • Heparin cofactor II panel
  • Heparin cofactor II, %
  • N-telopeptide, serum, nmol BCE
  • NUDT15 genotype
  • NUDT15 metabolic activity
  • Potassium, blood, mEq/L
  • pneumoniae serotype 15 (15B)
  • pneumoniae serotype 15B Ab, IgG
  • TPMT metabolic activity
  • Unidentified abnormal cell, peripheral blood
  • Urine dipstick w/reflex panel

Medications

Additions

  • 5-Amino-1MQ Oral
  • AB801 invest Oral
  • AOD-9604 Ipamorelin Compound Oral
  • AOD-9604 Acetate Oral
  • AT-1965 invest IV
  • Avutometinib invest (VS-6766 invest Oral)
  • BH3120 invest IV
  • DB-1303 invest IV
  • FB849 invest Oral
  • GSK4524101 invest Oral
  • GZ402671 invest Oral
  • KB-GDT-01 invest IV
  • Kisspeptin-10 Acetate Subcutaneous
  • KPV Acetate Oral
  • LM-24C5 invest IV
  • Mepilex Dressing
  • OP-1250 invest Oral
  • Palazestrant invest (OP-1250 invest Oral)
  • Venglustat invest (GZ402671 invest Oral)

Updates

Medication Update
Ketamine Topical Cream (Ketamine 5%, Lidocaine 4%) Disabled eRx in the Order Editor
Morphine Oral ER Tab New default Form available:

  • 15 mg tablet extended release
MRTX1719 invest Oral New Form available:

  • 200 mg tablet
Nivolumab-Relatlimab-rmbw IV 240 mg-80 mg/20 mL New default Sig available:

  • 40 mL intravenously Piggyback once

New Instructions available:

  • Dose of 40 mL is equivalent to Nivolumab 480 mg- Relatlimab-rmbw 160 mg (two 20 mL vials). Administer undiluted or diluted in NS or D5W. Refer to product Prescribing Information to determine infusion volume and concentration based on patient body weight. Gently invert the bag to mix. Do not shake. Administer through an IV line containing a sterile, non-pyrogenic, low protein binding in-line polyethersulfone (PES), nylon, or polyvinylidene fluoride (PVDF) filter (pore size 0.2 micrometer to 1.2 micrometer). Flush after infusion. Do not mix or administer with other drugs. NOTE: This is Opdualag.
Oxycodone Oral 12 hr Sprinkle Cap New default Form available:

  • 18 mg cap, sprinkle, ER12hr (DON’T CRUSH)New Instructions available:
  • Take with food.New Maximum Single Dose available:
  • 288 mg/day
Oxycodone Oral Liquid New default Form available:

  • 5 mg/5 mL solution

New default Sig available:

  • 5 mL orally every 4 to 6 hours PRN for pain
Pegfilgrastim-cbqv Subcutaneous Auto-Injector New Maximum Single Dose available:

  • 6 mg

New Instructions available:

  • Administer 24 hours after chemotherapy. See Instructions for Use. NOTE: This is Udenyca Auto-Injector.
RO7198457 invest IV New Form available:

  • 40 mcg/vial solution
TAK-573 invest IV New Form available:

  • 50 mg recon soln
triptorelin IM 11.25 mg New Maximum Single Dose available:

  • 11.25 mg
triptorelin IM 22.5 mg New Maximum Single Dose available:

  • 22.5 mg

Regimen Library

Rash Prophylaxis in Panitumumab and Cetuximab Regimens

To improve ease of ordering and serve as a reminder for prescribers, CCC voted to add doxycycline 100 mg PO daily and hydrocortisone 1% cream BID for 6 weeks as optional, un- checked prescriptions in panitumumab and cetuximab-containing regimens.

Nyvepria™ Precheck in Long-Acting G-CSF containing Regimens

After reviewing utilization trends, economics, and commercial coverage, the P&T Executive Committee voted to precheck Nyvepria™ (pegfilgrastim-apgf) in all regimens containing long-acting G-CSFs.

  • Regimens making up 90% of long-acting G-CSF utilization will be updated with the November Content Release.
  • Remaining regimens will be updated with the December Content Release (date TBD).

Additions

Regimen Name Diagnosis
Bevacizumab (10 mg/kg) D1,15 + Erlotinib Q28D (RCC) Renal Cell Carcinoma (RCC)
Cetuximab D1,15 + Adagrasib Q28D Colon Cancer, Rectal Cancer
Cetuximab D1,15 + Sotorasib Q28D Colon Cancer, Rectal Cancer
Isatuximab-irfc IV + Lenalidomide + Bortezomib + Dexamethasone (RVD) Q42D Multiple Myeloma (MM)
Pembrolizumab + Gemcitabine D1,8 + Cisplatin D1,8 Q21D (Bile Duct) Bile Duct Cancer (Parent)
Pembrolizumab + Ifosfamide CIV D2 + Carboplatin D2 + Etoposide D1-3 (ICE) Q21D Lymphoma, Hodgkin (HL)
Vedolizumab SQ D1,15 Q28D (Maintenance) (UC) Ulcerative Colitis

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
  • Bladder Cancer
  • Breast Cancer
  • Castleman’s Disease
  • Colon Cancer
  • Crohn’s Disease
  • Fallopian Tube Cancer
  • Head and Neck Cancer (Parent)
  • Lung Cancer, Non-small Cell (NSCLC)
  • Lymphoma, Hodgkin (HL)
  • Lymphoma, Non-Hodgkin (NHL) (Parent)
  • Melanoma, Skin
  • Multiple Myeloma (MM)
  • Ovarian and Primary Peritoneal Cancer
  • Prostate Cancer
  • Rectal Cancer
  • Renal Pelvis and Ureter Cancer
  • Sarcoma, Bone (Parent)
  • Sarcoma, Soft Tissue (Parent)
  • Ulcerative Colitis
  • Urethral Cancer
  • Uterine Cancer (Parent)

Renames

Previous Name New Name
Vedolizumab D1,15,43 Q98D (Induction) Vedolizumab IV D1,15 Q42D (Induction) (Crohn’s, UC)
Vedolizumab Q56D (Maintenance) Vedolizumab IV Q56D (Maintenance) (Crohn’s, UC)

Research

Updates

Updated Reference Information Updated Drug Service Order Information Updated Regimen Instructions Other Changes
USOR 20139 X
USOR 20144 X
USOR 20398 X X
USOR 21353 X X X
USOR 21386 X X
USOR 21457 X X
USOR 21533 X X X Now available:

USOR 21533 Bioavailability Run-In MRTX1719 (Treatment A fb Treatment B)
USOR 21533 Bioavailability Run-In MRTX1719 (Treatment B fb Treatment A)
USOR 21552 X X
USOR 22003 X
USOR 22074 X X Now available:

USOR 22074 Bendamustine D1,2 + Rituximab IV fb SQ (BR) Q28D USOR 22074 Lenalidomide D1-21 + Rituximab IV fb SQ D1,8,15,22 fb D1 Q28D
USOR 22074 Rituximab IV fb SQ + CHOP Q21D
USOR 22083 X X X
USOR 22093 X X
USOR 22133 X
USOR 22169 X
USOR 22302 X
USOR 23010 X X X
USOR 23080 X
USOR 23091 X X
USOR 23108 X X X
USOR 23166 X

Billing & HCPCS Codes

Updates

Medication HCPCS Codes
Amisulpride (Barhemsys) J3490 per:

  • 5 mg
  • 10 mg
Carmustine (see NDC-HCPCS crosswalk) J9999 per:

  • 50 mg
  • 300 mg
Cefazolin (see NDC-HCPCS crosswalk) J3490 per:

  • 2 gram
  • 3 gram
Cipaglucosidase alfa-atga (Pombiliti) J3590 per 105 mg
Fluphenazine J3490 per 1.25 mg
Mirikizumab-mrkz J3590 per 300 mg
Mirikizumab-mrkz Subcutaneous Pen Injector (Omvoh) J3590 per 100 mg
Motixafortide (Aphexda) J3490 per 62 mg
Nicardipine (Cardene) J3490 per:

  • 0.5 mg/hour
  • 1 mg/hour
  • 20 mg/hour
  • 25 mg/hour
  • 40 mg/hour

NDC to HCPCS Crosswalk

Additions

Medication (Brand) HCPCS Code NDC
Carmustine J9999 16729054305
16729054563
16729054601
16729054863
Cefazolin J3490 00143913901
00143913925
00143914001
00143914025