September 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.
Line of Therapy has been updated for Small cell, lung cancer with the following documentation points:
- Consolidation (limited stage) is now available
- Maintenance (extensive stage) is now available
- Maintenance is no longer available
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.
To appropriately align ICD-10 codes within problems, “I10 – Essential (primary) hypertension” was removed from the following problems:
- Brachydactyly syndrome type E (disorder)
- Chronic hypertension in obstetric context (disorder)
- Dementia due to hemorrhagic cerebral infarction due to hypertension (disorder)
- Dementia due to hypertensive encephalopathy (disorder)
- Dementia due to metabolic abnormality (disorder)
- Essential hypertension in obstetric context (disorder)
- Good hypertension control (finding)
- Headache due to arterial hypertension (finding)
- Hemorrhagic cerebral infarction (disorder)
- Hemorrhagic cerebral infarction due to hypertension (disorder)
- Hemorrhagic infarction (disorder)
- Hereditary dysplasia of blood vessel (disorder)
- Hypertension in the obstetric context (disorder)
- Hypertension monitoring offer default (finding)
- Hypertension monitoring status (finding)
- Hypertensive optic neuropathy (disorder)
- Hypertensive treatment changed (situation)
- Increased blood pressure (finding)
- Progressive arterial occlusive disease, hypertension, heart defect, bone fragility, brachysyndactyly syndrome (disorder)
- Transient hypertension (disorder)
- Ulcer of lower leg due to arterial hypertension (disorder)
- Ulcer of lower limb due to arterial hypertension (disorder)
Lab Analytes & Panels
Additions
Lab Analytes
- Amyloidosis DNA sequence gene analyzed
- Amyloidosis DNA sequence test description
- Brushite saturation
- Calcium/Kg body weight, mg/24hr/kg
- Calculus weight, mg
- Creatinine/Kg body weight, mg/24hr/kg
- Cystine capacity, mg/L
- Cystine saturation
- Cystine, quant, urine, mg/24hr
- Dako PD-L1 IHC 22C3
- Ehrlichia antibody panel comment
- Ganglioside (GQ1B) ab (IgG) panel
- Ganglioside (GQ1B) ab IgG titer
- Human influenza A virus subtype H1pdm09
- Infliximab interpretation
- Litholink 24hr cystine profile comment
- MyoMarker panel 3 plus
- pH, 24hr, urine
- Protein catabolic rate, g/kg/24hr
- T-cell receptor gamma tube A, BP
- T-cell receptor gamma tube B, BP
- Thrombin antithrombin complex AG, ug/L
- Urine volume (preserved), mL/24hr
Panels
MuSK antibody panel
- MuSK antibody, nmol/L
Platelet antibody screen panel
- Platelet antibody screen overall result
- Platelet antibody screen interpretation
- GPIIb/IIIa (cell-1)
- GPIIb/IIIa (cell-2)
- GPIa/IIa (cell-1)
- GPIa/IIa (cell-2)
- GPIb/IX
- GPIV
- HLA class I antibody
- Platelet antibody screen reason for request
- IVIG in last month
Oxalate, blood panel
- Oxalate, blood, umol/L
Cystatin C with estimated GFR panel
- EGFR by Cystatin C, mL/min/BSA
- Cystatin C
Bone marrow AFB culture panel
- Bone marrow AFB culture
Non gyn cytology w/reflex panel
- Pathology/Cytology clinical history
- Pathology/Cytology source of specimen
- Pathology/Cytology gross description
- Pathology/Cytology specimen adequacy
- Pathology/Cytology diagnosis
- Pathology/Cytology note
- Pathology/Cytology screened by
- Pathology/Cytology reviewed by
FISH, MDS/Myeloid panel
- FISH, MDS/Myeloid result
Medications
Additions
- 225Ac-DOTATATE invest (RYZ101 invest IV)
- ALT2618 invest Oral
- AMT-116 invest IV
- BGB-11417 invest Oral
- DM005 invest IV
- Fianlimab-Cemiplimab invest (REGN3767-REGN2810 invest IV)
- KQB198 invest Oral
- LOXO-435 invest Oral
- Miracle Mouthwash (Diphenhydramine- Dexamethasone-Nystatin)
- MK-1026 invest Oral
- Nemtabrutinib invest (MK-1026 invest Oral)
- REGN3767-REGN2810 invest IV
- RP1-104 invest Intratumoral
- RYZ101 invest IV
- Sonrotoclax invest (BGB-11417 invest Oral)
- Vusolimogene Oderparepvec invest (RP1-104 invest Intratumoral)
Updates
| Medication | Update |
| ATRN-119 invest Oral | New form available: 100 mg capsule |
| BBO-10203 invest Oral | New form available: 150 mg tablet |
| Bevacizumab IV | Updated drug instructions: Dilute with NS to a total volume of 100 ml. Administer over 30 minutes. NOTE: This is Avastin. |
| Bevacizumab-adcd IV | Updated drug instructions: Dilute with NS to a total volume of 100 ml. Administer over 30 minutes. NOTE: This is Vegzelma. |
| Bevacizumab-awwb IV | Updated drug instructions: Dilute with NS to a total volume of 100 ml. Administer over 30 minutes. NOTE: This is Mvasi. |
| Bevacizumab-bvzr IV | Updated drug instructions: Dilute with NS to a total volume of 100 ml. Administer over 30 minutes. NOTE: This is Zirabev. |
| Ferric Derisomaltose IV | Added maximum single dose: 1,000 mg |
| Hyaluronate Sodium, Stabilized Intra- Articular 60 mg/3 mL | Brand name linked to Generic name: Durolane |
| Ianalumab (VAY736) invest IV | New quick sig available: 0 mL intravenously once |
| MGA012 invest IV | Update drug name: Retifanlimab invest IV |
| SPYK04 invest Oral | New form available: 0.2 mg capsule New quick sig available: 0.2 mg orally daily; Take every 24 hours with water on an empty stomach (no food or >drink other than water for at least 2 hours prior to dose and at least 1 hour after dose). Take in clinic when instructed. Store in refrigerator. |
| tovorafenib Suspension via feeding tube | New maximum single dose: 600 mg via feeding tube New drug instructions: Take with or without food New quick sigs available:
|
| Vorasidenib Oral | New drug instructions: Take with or without food. New quick sigs available: 40 mg orally As Directed |
| Ziftomenib invest (KO-539 invest Oral) | New quick sigs available:
|
Regimen Library
Bispecific Antibody Monitoring
To promote best practices and increase patient safety, Bispecific Antibody Monitoring communication orders have been added to Multiple Myeloma bispecific antibody regimen templates.
The Collaborative Care Committee has voted in favor of the addition of the communication orders with contingencies to include updated formatting highlighting drug-specific recommendations.
These updates will be implemented in a future content release.
Additions
| Regimen Name | Diagnosis |
| Daratumumab IV + Carfilzomib D1,2,8,9,15,16 fb D1,2,15,16 + Pomalidomide D1-21 + Dexamethasone Q28D | Multiple Myeloma (MM) |
| Daratumumab IV + Carfilzomib D1,2,8,9,15,16 fb D1,2,15,16 + Pomalidomide D1-21 + Dexamethasone Q28D (C1 Split Dosing) | Multiple Myeloma (MM) |
| Daratumumab SQ + Carfilzomib D1,2,8,9,15,16 fb D1,2,15,16 + Pomalidomide D1-21 + Dexamethasone Q28D | Multiple Myeloma (MM) |
| Durvalumab + Gemcitabine D1,8 + Cisplatin Q21D (NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Durvalumab + Paclitaxel + Carboplatin Q21D (NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Durvalumab + Pemetrexed + Carboplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Durvalumab + Pemetrexed + Cisplatin Q21D | Lung Cancer, Non-small Cell (NSCLC) |
| Durvalumab Q28D (Flat Dose) (Perioperative NSCLC) | Lung Cancer, Non-small Cell (NSCLC) |
| Lazertinib + Amivantamab-vmjw (weight greater than or equal to 80 kg) D1,15 Q28D | Lung Cancer, Non-small Cell (NSCLC) |
| Lazertinib + Amivantamab-vmjw (weight less than 80 kg) D1,15 Q28D | 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
- Arthritis, Rheumatoid
- Bile Duct Cancer (Parent)
- Bladder Cancer
- Breast Cancer
- Cervical Cancer
- Colon Cancer
- Esophageal Cancer (Parent)
- Fallopian Tube Cancer
- Gallbladder Cancer
- Gastric Cancer
- Head and Neck Cancer (Parent)
- Hepatocellular Carcinoma (HCC)
- Lung Cancer, Non-small Cell (NSCLC)
- Lung Cancer, Small Cell (SCLC)
- Lymphoma, Non-Hodgkin (NHL) (Parent)
- Melanoma, Skin
- Melanoma, Uvea, Ciliary Body/Choroid
- Melanoma, Uvea, Iris
- Multiple Myeloma (MM)
- Myelodysplastic Syndrome (MDS)
- Ovarian and Primary Peritoneal Cancer
- Pancreatic Cancer
- Paroxysmal Nocturnal Hemoglobinuria
- Rectal Cancer
- Renal Cell Carcinoma (RCC)
- Renal Pelvis and Ureter Cancer
- Sarcoma, Bone (Parent)
- Sarcoma, Soft Tissue (Parent)
- Solid Tumors (Parent) (including Solid Other/HL)
- Urethral Cancer
- Uterine Cancer (Parent)
Renames
| Previous Name | New Name |
| Ado-trastuzumab emtansine Q21D | Ado-Trastuzumab Emtansine (Kadcyla) Q21D |
| Ado-Trastuzumab Emtansine Q21D (Adjuvant Breast Residual Disease) | Ado-Trastuzumab Emtansine (Kadcyla) Q21D (Adjuvant Breast Residual Disease) |
| Ado-Trastuzumab emtansine Q21D (Initial Adjuvant Breast) | Ado-Trastuzumab Emtansine (Kadcyla) Q21D (Initial Adjuvant Breast) |
| Fam-Trastuzumab Deruxtecan-nxki (5.4 mg/kg) Q21D | Fam-Trastuzumab Deruxtecan-nxki (Enhertu) (5.4 mg/kg) Q21D |
| Fam-Trastuzumab Deruxtecan-nxki (6.4 mg/kg) Q21D. | Fam-Trastuzumab Deruxtecan-nxki (Enhertu) (6.4 mg/kg) Q21D |
| Mosunetuzumab-axgb D1,8,15 fb D1 Q21D | Mosunetuzumab-axgb (Lunsumio) D1,8,15 fb D1 Q21D |
| Obinutuzumab D1 fb Glofitamab-gxbm D8,15 fb D1 Q21D | Obinutuzumab D1 fb Glofitamab-gxbm (Columvi) D8,15 fb D1 Q21D |
| Tarlatamab-dlle IV D1,8,15 fb D1,15 Q28D | Tarlatamab-dlle (Imdelltra) D1,8,15 fb D1,15 Q28D |
| Tebentafusp-tebn D1,8,15 Q21D (Initial) | Tebentafusp-tebn (Kimmtrak) D1,8,15 Q21D (Initial) |
| Tebentafusp-tebn D1,8,15,22 Q28D (Maintenance) | Tebentafusp-tebn (Kimmtrak) D1,8,15,22 Q28D (Maintenance) |
| Teclistamab-cqyv SQ D1,4,7 (Initial) | Teclistamab-cqyv (Tecvayli) SQ D1,4,7 (Initial) |
| Teclistamab-cqyv SQ D1,8,15,22 fb D1,15 Q28D (Maintenance) | Teclistamab-cqyv (Tecvayli) SQ D1,8,15,22 fb D1,15 Q28D (Maintenance) |
| Teclistamab-cqyv SQ Option D1,3,5 (Initial) | Teclistamab-cqyv (Tecvayli) SQ Option D1,3,5 (Initial) |
Removals
| Regimen Name | Diagnosis |
| Daratumumab SQ + Bortezomib + Thalidomide + Dexamethasone Q28D (Part 1 of 2: Induction) | Multiple Myeloma (MM) |
| Daratumumab SQ + Bortezomib + Thalidomide + Dexamethasone Q28D (Part 2 of 2: Post-transplant Consolidation) | Multiple Myeloma (MM) |
| Daratumumab IV + Ixazomib D1,8,15 + Lenalidomide D1-21 + Dexamethasone Q28D | Multiple Myeloma (MM) |
| Daratumumab SQ + Ixazomib D1,8,15 + Lenalidomide D1-21 + Dexamethasone Q28D | Multiple Myeloma (MM) |
| Daratumumab IV + Bortezomib + Melphalan PO + Prednisone Q42D (Part 1 of 2) | Multiple Myeloma (MM) |
| Daratumumab IV + Bortezomib + Melphalan PO + Prednisone Q42D (Part 1 of 2: C1 Split Dosing) | Multiple Myeloma (MM) |
| Daratumumab IV + Bortezomib + Melphalan PO + Prednisone Q28D (Part 2 of 2: Daratumumab IV only) | Multiple Myeloma (MM) |
| Daratumumab SQ + Bortezomib + Melphalan PO + Prednisone Q42D (Part 1 of 2) | Multiple Myeloma (MM) |
| Daratumumab SQ + Bortezomib + Melphalan PO + Prednisone Q28D (Part 2 of 2: Daratumumab SQ only) | Multiple Myeloma (MM) |
Villing & HCPCS Codes
Updates
The October 2024 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.
- The complete HCPCS Application Summaries and Coding Recommendations can be found here.
- The complete list of October 2024 HCPCS quarterly updates, can be found on CMS’s
For medications listed below that include a brand name, please refer to the NDC – HCPCS crosswalk table within the release notes for specific dispensable/NDC association.
| Medication | HCPCS Codes |
| Acetaminophen and Ibuprofen Injection | J0138 Per 1000 mg |
| Capecitabine Oral | J8522 per 50 mg |
| Dexamethasone Oral | J8541 per 0.25 mg |
| Dexamethasone Oral (Hemady) | J8541 per 0.25 mg |
| Hydromorphone Injection | J1171 per 0.1 mg |
| Influenza virus vaccine IM Tri-Split (6 months & older) Cell derived | 90661 per 0.5 mL |
| Lidocaine (Baxter) | J2002 per 1 mg |
| Lidocaine (Braun) | J2002 per 1 mg |
| Lidocaine (Fresenius Kabi) | J2003 per 1 mg |
| Lidocaine (Hospira) | J2003 per 1 mg |
| Lidocaine (International Medication Systems) | J2003 per 1 mg |
| Midazolam | J2252 per 1 mg |
| Nemolizumab-ilto Subcutaneous Pen Injector | J3590 per 30 mg |
| Palonosetron IV | J2468 per 0.25 mg |
| Palopegteriparatide Subcutaneous Pen Injector | J3590 per 168 mcg |
| Pneumococcal 21-val conj-dip crm (PF) IM | 90684 per 0.5 mL |
| Rocuronium IV | J3490 per 1 mg |
| Tislelizumab-jsgr Injection | J9329 per 1 mg |
| Tocilizumab-aazg IV | Q5135 per 1 mg |
| Tocilizumab-aazg Subcutaneous | Q5135 per 1 mg |
| Vasopressin Continuous Intra-Arterial Infusion | J2601 per 1 unit |
| Vasopressin IV | J2601 per 1 unit |
ICD-10-CM
Updates
The upcoming FY25 CMS changes to the ICD-10-CM coding guidelines and code set effective on Oct. 1, 2024, have been released. The complete code set changes can be found here.
NDC – HCPCS Crosswalk
Additions
| Medication (Brand) | HCPCS Code | NDC |
| Bendamustine (Treanda) | J9033 per 1 mg |
|
| Dexamethasone (Hemady) | J8541 per 0.25 mg |
|
| Lidocaine (Baxter) | J2002 per 1 mg |
|
| Lidocaine (Braun) | J2002 per 1 mg |
|
| Lidocaine (Fresenius Kabi) | J2003 per 1 mg |
|
| Lidocaine (Hospira) | J2003 per 1 mg |
|
| Lidocaine (International Medication Systems) | J2003 per 1 mg |
|
| Midazolam | J2252 per 1 mg |
|
| Palonosetron (Avyxa) | J2468 per 0.25 mg |
|
| Vasopressin (Baxter) | J2601 per 1 unit |
|