October 2024 Content Release Copied
Clinical Profile Documentation
Problem Groups
Additions
The Problems > Add Details area is updated with applicable documentation points for the following diagnoses.
HER2 by IHC was updated for Biliary Tract Cancers, Bladder Cancer, Breast Cancer, Cervical Cancer, Colon Cancer, Esophageal Cancer, Fallopian Tube Cancer, Gastric Cancer, Head and Neck Cancer, Melanoma, Lung Cancer, Non-small Cell (NSCLC), Ovarian and Primary Peritoneal Cancer, Pancreatic Cancer, Rectal Cancer, and Uterine Cancer with the following documentation points:
- 3+
- 2+
- 1+
- 0
- Unknown
HER2 by ISH was updated for Breast Cancer with the following documentation points:
- Positive
- Negative
- Unknown
HER2 by ISH or NGS is now available for Biliary Tract Cancers, Cervical Cancer, Colon Cancer, Esophageal Cancer, Gastric Cancer, Rectal Cancer, and Uterine Cancer with the following documentation points:
- Positive
- Negative
- Unknown
HER2 status was updated for Breast Cancer with the following documentation points:
- Positive: IHC 3+ or IHC 2+/ISH-positive
- Low: IHC 1+ or IHC 2+/ISH-negative
- Negative: IHC 0
- Unknown
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 below for a complete summary of changes.
Lab Analytes & Panels
Analyte Additions
- CYP2C cluster geno
- CYP2C cluster pheno
- CYP2C9 genotype
- CYP2C9 phenotype
- CYP4F2 genotype
- CYP4F2 phenotype
- HBV genotype + drug resistance
- LDL calculation comment
- Total cells counted, CSF
- VKORC1 phenotype
- West Nile virus IgM, CSF
Panel Additions
- HBV genotype + drug resistance panel
- Jak2 mutation, quantitative w/reflex to Exons 12-15 panel
- Myeloma, FISH panel, tissue panel
- Genetic result summary
- Genetic interpretation
- Genetic result table
- Genetic reason for referral
- Genetic specimen
- Genetic source
- Genetic tissue ID
- Genetic method
- Genetic disclaimer
- Genetic released by
Medications
Additions
- CB-010 invest IV
- IFx-Hu2.0 invest Intralesional
- INCB057643 invest Oral
- Olvimulogene Nanivacirepvec (Olvi-Vec) invest IV
Updates
| Medication | Update |
| AZD5305 invest Oral | New Alias: Saruparib invest (AZD5305 invest Oral) |
| Tecentriq Hybreza (atezolizumab- hyaluronidase-tqjs Subcutaneous 1,875 mg-30,000 unit/15 mL) | New SIG: 1,875 mg subcutaneously every 3 weeks; administer over 7 minutes; administer in the thigh over approximately 7 minutes. |
| VET3-TFI invest Intratumoral | New Units:
Deactivated Units:
|
| VET3-TGI invest IV | New Units:
Deactivated Units:
|
Regimen Library
Additions
| Regimen Name | Diagnosis |
| Atezolizumab SQ Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Atezolizumab SQ Q21D (Adjuvant NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Atezolizumab SQ + Abraxane D1,8,15 + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Atezolizumab SQ + Bevacizumab Q21D | Hepatocellular Carcinoma (HCC) |
| Atezolizumab SQ + Bevacizumab + Paclitaxel + Carboplatin Q21D (Part 1 of 2: Induction) | Lung Cancer, Non-small Cell (NSCLC) |
| Atezolizumab SQ + Bevacizumab + Paclitaxel + Carboplatin Q21D (Part 2 of 2: Atezolizumab SQ + Bevacizumab Maintenance) | Lung Cancer, Non-small Cell (NSCLC) |
| Atezolizumab SQ + Carboplatin + Etoposide D1-3 Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Influenza Vaccines 2024-2025 | All Problems |
| Isatuximab-irfc + Carfilzomib D1,8,15 + Lenalidomide D1-21 + Dexamethasone Q28D | Multiple Myeloma (MM) |
| Isatuximab-irfc IV + Lenalidomide + Bortezomib + Dexamethasone (RVD) Q42D (Part 2 of 2: Isatuximab-irfc IV + Lenalidomide + Dexamethasone Continuation Q28D, non-transplant candidates) | Multiple Myeloma (MM) |
| Pembrolizumab + Pemetrexed + Carboplatin Q21D (Mesothelioma) | Malignant Mesothelioma; Malignant Pleural Mesothelioma |
| Pembrolizumab + Pemetrexed + Cisplatin Q21D (Mesothelioma) | Malignant Mesothelioma; Malignant Pleural Mesothelioma |
| Tislelizumab-jsgr Q21D | Esophageal Cancer (Parent); Hepatocellular Carcinoma (HCC) |
| Vemurafenib + Cobimetinib Q28D fb Vemurafenib + Cobimetinib (Q28D) + Atezolizumab SQ (Q21D) Q84D (Part 1 of 2) | Melanoma, Skin |
| Vemurafenib + Cobimetinib Q28D fb Vemurafenib + Cobimetinib (Q28D) + Atezolizumab SQ (Q21D) Q84D (Part 2 of 2) | Melanoma, Skin |
| Venetoclax + Azacitidine D1-7 Q28D (AML) | Leukemia, Acute Myeloid (AML) |
| Venetoclax + Decitabine D1-5 Q28D (AML) | Leukemia, Acute Myeloid (AML) |
| Zoledronic acid (Zometa) Q28D (Hypercalcemia of Malignancy) | All Malignancies |
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
- Esophageal Cancer (Parent)
- Fallopian Tube Cancer
- Gastric Cancer
- Hemolytic Uremic Syndrome
- Leukemia, Acute Myeloid (AML)
- Lymphoma, Hodgkin (HL)
- Lymphoma, Non-Hodgkin (NHL) (Parent)
- Multiple Myeloma
- Myasthenia Gravis
- Myelodysplastic Syndrome (MDS)
- Myelofibrosis
- Myeloproliferative Disorder
- Ovarian and Primary Peritoneal Cancer
- Paroxysmal Nocturnal Hemoglobinuria
- Polycythemia Vera
- Thalassemia
- Uterine Cancer (Parent)
- Waldenstrom’s Macroglobulinemia
Renames
| Previous Name | New Name |
| Isatuximab-irfc IV + Lenalidomide + Bortezomib + Dexamethasone (RVD) Q42D | Isatuximab-irfc IV + Lenalidomide + Bortezomib + Dexamethasone (RVD) Q42D (Part 1 of 2: Induction) |
| Venetoclax + Azacitidine D1-7 Q28D | Venetoclax + Azacitidine D1-7 Q28D (Myelofibrosis) |
| Venetoclax + Decitabine D1-5 Q28D | Venetoclax + Decitabine D1-5 Q28D (MDS, Myelofibrosis) |
Removals
| Regimen Name | Diagnosis |
| Atezolizumab + Abraxane D1,8 Q14D fb
Atezolizumab + Doxorubicin + Cyclophosphamide (AC) Q14D Dose Dense |
Breast Cancer |
| Atezolizumab Q21D (Adjuvant Breast) | Breast Cancer |
| Voxelotor Q30D | Anemia, Sickle Cell |
Billing & HCPCS Codes
Updates
| Medication | HCPCS Codes |
| Anthrax immune globulin (human) IV | J1599 per 60 units |
| Guselkumab IV | J1628 per 1 mg |
| Guselkumab Subcutaneous Pen Injector | J1628 per 1 mg |
| Influenza virus vaccine (PF) IM Tri-Split 65 yrs & older (High-Dose) | 90662 per:
|
| Ocrelizumab-hyaluronidase-ocsq Subcutaneous | J3590 per 23 mL |
| Palonosetron IV | J2469 per 0.025 mg |
| Pentamidine IV | J3490 per 300 mg |
Appendix A
Problem & Code Summary
For the retired and replacement problems listed below, please follow steps 1-9 to update the patient records in the iKM Clinical Profile, problems area to support regimen management:
- Locate the replacement problem in the second column
- Chart the replacement problem in iKM Clinical Profile, Problems
- Go to the patients flow sheet
- Select the regimen
- Select Edit regimen properties
- Select drop-down for Associated problem, select the new replacement problem
- Select Line of Therapy drop-down and select
- Save
- Document problem information (staging, biomarkers) in new problem
| Retired Problem | Replacement Problem |
| Benign carcinoid tumor of left kidney | Well-differentiated neuroendocrine tumor of left kidney |
| Benign neoplasm of left female breast | Benign neoplasm of left breast |
| Benign neoplasm of right female breast | Benign neoplasm of right breast |
| Infiltrating ductal carcinoma of central portion of left female breast | Infiltrating duct carcinoma of central portion of left breast |
| Infiltrating ductal carcinoma of central portion of right female breast | Infiltrating duct carcinoma of central portion of right breast |
| Infiltrating ductal carcinoma of lower inner quadrant of left female breast | Infiltrating duct carcinoma of lower inner quadrant of left breast |
| Infiltrating ductal carcinoma of lower inner quadrant of right female breast | Infiltrating duct carcinoma of lower inner quadrant of right breast |
| Infiltrating ductal carcinoma of lower outer quadrant of left female breast | Infiltrating duct carcinoma of lower outer quadrant of left breast |
| Infiltrating ductal carcinoma of lower outer quadrant of right female breast | Infiltrating duct carcinoma of lower outer quadrant of right breast |
| Infiltrating ductal carcinoma of upper inner quadrant of left female breast | Infiltrating duct carcinoma of upper inner quadrant of left breast |
| Infiltrating ductal carcinoma of upper inner quadrant of right female breast | Infiltrating duct carcinoma of upper inner quadrant of right breast |
| Infiltrating ductal carcinoma of upper outer quadrant of left female breast | Infiltrating duct carcinoma of upper outer quadrant of left breast |
| Infiltrating ductal carcinoma of upper outer quadrant of right female breast | Infiltrating duct carcinoma of upper outer quadrant of right breast |
| Infiltrating lobular carcinoma of right female breast | Lobular carcinoma of right breast |
| Primary malignant neoplasm of bilateral female breasts | Primary malignant neoplasm of bilateral breasts |
| Recurrent primary malignant neoplasm of left female breast | Recurrent primary malignant neoplasm of left breast |
| Recurrent primary malignant neoplasm of right female breast | Recurrent primary malignant neoplasm of right breast |
Additions
The following problem to ICD-10-CM mappings will be available in the Clinical Profile, Problems area of iKnowMed. The ICD-10-CM codes you see below are new as of Tuesday, Oct. 1, 2024.
| Problem | ICD-10 Codes |
| Adverse reaction to drug |
|
| Aftercare | Z51.A Encounter for sepsis aftercare |
| Anal fistula |
|
| Anaplastic large cell lymphoma, ALK negative | C84.7B Anaplastic large cell lymphoma, ALK-negative, in remission |
| Anaplastic lymphoma kinase positive anaplastic large cell lymphoma | C84.6A Anaplastic large cell lymphoma, ALK-positive, in remission |
| Angioimmunoblastic T-cell lymphoma |
|
| Anorectal fistula |
|
| Anosognosia | R41.85 Anosognosia |
| B-cell lymphoma | C85.1A Unspecified B-cell lymphoma, in remission |
| Bicuspid aortic valve | Q23.81 Bicuspid aortic valve |
| Blastic plasmacytoid dendritic cell neoplasm | C86.40 Blastic NK-cell lymphoma not having achieved remission |
| Burkitt’s lymphoma (clinical) | C83.7A Burkitt lymphoma, in remission |
| Carcinoid heart disease | E34.01 Carcinoid heart syndrome |
| Carcinoid syndrome |
|
| Central centrifugal cicatricial alopecia | L66.81 Central centrifugal cicatricial alopecia |
| Childhood obesity |
|
| Cholestatic pruritus | L29.81, Cholestatic pruritus |
| Cleft leaflet of mitral valve | Q23.82 Congenital mitral valve cleft leaflet |
|
Q23.88 Other congenital malformations of aortic and mitral valves |
| Degeneration of lumbar intervertebral disc |
|
| Degeneration of lumbosacral intervertebral disc |
|
| Dehiscence of surgical wound |
|
| Diffuse follicle center lymphoma | C82.5A Diffuse follicle center lymphoma, in remission |
| Diffuse large B-cell lymphoma |
|
| Diffuse non-Hodgkin’s lymphoma |
|
| Disorder of carbohydrate metabolism | E74.829 Other disorders of citrate metabolism |
| Disorder of carbohydrate transport | E74.820 SLC13A5 Citrate Transporter Disorder |
| Disorder of skeletal muscle | M62.85 Dysfunction of the multifidus muscles, lumbar region |
| Edema |
|
| Enteropathy-associated T-cell lymphoma | C86.20 Enteropathy-type (intestinal) T-cell lymphoma not having achieved remission |
| Enteropathy-type (intestinal) T-cell | C86.21 Enteropathy-type (intestinal) T-cell lymphoma, in remission |
| Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT-lymphoma) |
|
| Extranodal NK/T-cell lymphoma, nasal type |
|
| Family history of familial multiple | Z83.72 Family history of familial adenomatous polyposis |
| Fanconi’s anemia | D61.03 Fanconi anemia |
| Finding of receipt of benefit status | Z59.72 Insufficient welfare support |
| Finding related to health insurance issues | Z59.71 Insufficient health insurance coverage |
| Follicular lymphoma |
|
| Follicular lymphoma grade 3a | C82.3A Follicular lymphoma grade IIIa, in remission |
| Follicular lymphoma grade 3b | C82.4A Follicular lymphoma grade IIIb, in remission |
| Follicular non-Hodgkin’s lymphoma, large cell | C82.2A, Follicular lymphoma grade III, unspecified, in remission |
| Follicular non-Hodgkin’s lymphoma, mixed small, cleaved cell and large cell (disorder) | C82.1A Follicular lymphoma grade II, in remission |
| Follicular non-Hodgkin’s lymphoma, small, cleaved cell (clinical) | C82.0A Follicular lymphoma grade I, in remission |
| Frontal fibrosing alopecia | L66.12 Frontal fibrosing alopecia |
| Fy(a-b-) phenotype | Z67.A1 Duffy null |
| Fy(a-b+) phenotype | Z67.A3 Duffy b positive |
| Fy(a+b-) phenotype | Z67.A2 Duffy a positive |
| Fy(a+b+) phenotype | Z67.A4 Duffy a and b positive |
|
Gastrointestinal anastomotic dehiscence |
|
| Genetic susceptibility to genetic disorder |
|
| Heavy chain disease |
|
|
Hepatosplenic T-cell lymphoma |
|
|
History of adenomatous polyp of colon |
|
|
History of drug therapy |
Z92.26 Personal history of immune checkpoint inhibitor therapy |
|
History of polyp of colon |
|
|
Hodgkin lymphoma lymphocytic depletion |
C81.3A Lymphocyte depleted Hodgkin lymphoma, in remission |
|
Hodgkin’s disease in remission |
|
|
Hodgkin’s disease, nodular sclerosis |
|
| Hormone receptor negative neoplasm |
|
| Hormone receptor positive tumor |
|
| Human epidermal growth factor 2 gene amplification not detected | Z17.32 Human epidermal growth factor receptor 2 negative status |
| Human epidermal growth factor receptor 2 gene amplification detected | Z17.31 Human epidermal growth factor receptor 2 positive status |
| Hypoglycemia |
|
|
Immunoproliferative small intestinal disease (clinical) |
|
| Intentional poisoning by drug |
|
| Intentional self-poisoning |
|
| Itching of skin | L29.89 Other pruritus |
| Kleefstra syndrome | Q87.86 Kleefstra syndrome |
| Lichen planopilaris |
|
| Lymphocyte-rich classical Hodgkin lymphoma | C81.4A Lymphocyte-rich Hodgkin lymphoma, in remission |
| Malignant immunoproliferative disease (clinical) |
|
| Malignant lymphoma – small lymphocytic | C83.0A Small cell B-cell lymphoma, in remission |
| Mantle cell lymphoma | C83.1A Mantle cell lymphoma, in remission |
| Mature T-cell AND/OR NK cell neoplasm |
|
| Mixed cellularity Hodgkins lymphoma | C81.2A Mixed cellularity Hodgkin lymphoma, in remission |
| Mycosis fungoides (clinical) | C84.0A Mycosis fungoides, in remission |
| Non-Hodgkin’s lymphoma in remission | C85.8A Other specified types of non-Hodgkin lymphoma, in remission |
| Obese class I | E66.811 Obesity, class 1 |
| Obesity | E66.89 Other obesity not elsewhere classified |
| Obesity, class II | E66.812 Obesity, class 2 |
| Obesity, class III | E66.813 Obesity, class 3 |
| Peripheral T-cell lymphoma (clinical) | C84.4A Peripheral T-cell lymphoma, not elsewhere classified, in remission |
| Poisoning by drug AND/OR medicinal substance |
|
| Precursor cell lymphoblastic lymphoma | C83.5A Lymphoblastic (diffuse) lymphoma, in remission |
| Presymptomatic type 1 diabetes mellitus |
|
| Primary central nervous system lymphoma |
|
| Primary cutaneous CD30+ large T-cell lymphoma |
|
| Primary cutaneous follicular center B-cell lymphoma | C82.6A Cutaneous follicle center lymphoma, in remission |
| Primary cutaneous T-cell lymphoma | C84.AA Cutaneous T-cell lymphoma, unspecified, in remission |
| Primary mediastinal (thymic) large B-cell lymphoma | C85.2A Mediastinal (thymic) large B-cell lymphoma, in remission |
| Progesterone receptor negative neoplasm | Z17.22 Progesterone receptor negative status |
| Progesterone receptor positive tumor | Z17.21 Progesterone receptor positive status |
| Pulmonary embolism |
|
| Pulmonary fat embolism |
|
| Rectal fistula |
|
| Scarring alopecia | L66.89 Other cicatricial alopecia |
| Sezary’s disease | C84.1A Sezary disease, in remission |
| Stenosis of nasal valve |
|
| Subcutaneous panniculitis-like T-cell lymphoma |
|
| Synovitis and tenosynovitis |
|
| Synovitis and tenosynovitis of joint of hand |
|
| Synovitis and tenosynovitis of multiple joints |
|
|
|
|
|
| Synovitis/tenosynovitis – shoulder |
|
|
|
| Uses less medication than prescribed |
|
| Waldenström macroglobulinemia |
|
