On August 3, the Centers for Medicare and Medicaid Services (CMS) released the CY 2021 Physician Fee Schedule proposed rule. CMS is not proposing any changes to the values of the outpatient evaluation and management (E/M) services finalized in the CY 2020 rulemaking. If this rule is finalized as proposed, hematology/oncology is projected to see […]
Merck announced that CMS has made a status indicator change regarding ONTRUZANT®(trastuzumab-dttb), for injection, for intravenous use 21 mg/mL, which has a Q-code of Q5112. As of July 2020, Centers for Medicare & Medicaid Services (CMS) has issued a Corrected Addendum B to update the non-payable status for ONTRUZANT (Q5112) to Status Indicator “K”, which […]
ASTEX PHARMACEUTICALS, TAIHO ONCOLOGY, AND OTSUKA PHARMACEUTICAL ANNOUNCE FDA AND HEALTH CANADA APPROVAL OF INQOVI® (DECITABINE AND CEDAZURIDINE) TABLETS, ORAL HYPOMETHYLATING AGENT (HMA) THERAPY FOR INTERMEDIATE AND HIGH-RISK MDS AND CMML. Additional information is available at: https://www.taihooncology.com/us/news/2020-07-inqovi-approval/
Merck is pleased to announce that KEYTRUDA® (pembrolizumab) injection 100 mg has been approved by the FDA for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) that is not curable by surgery or radiation. • PD-L1 diagnostic testing is not required prior to initiating treatment with KEYTRUDA in these patients. PD-L1=programmed death ligand […]
Merck has informed OSCO that the Medicare Medically Unlikely Edit (MUE) value has been modified for KEYTRUDA® (pembrolizumab). The MUE for KEYTRUDA was modified effective July 1, 2020. A list of quarterly Procedure-to-Procedure and MUE version update changes from CMS can be found here. Payer coding and coverage requirements may vary or change over time, so it […]
Merck has announced that the FDA has approved KEYTRUDA® (pembrolizumab) for the first-line treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC). MSI-H/dMMR testing is required prior to initiating treatment with KEYTRUDA in these patients. For the MSI-H/dMMR indication, select patients for treatment with KEYTRUDA as a single agent based on MSI-H/dMMR status in […]
Takeda Oncology has announced that the US Food and Drug Administration (FDA) has approved the label expansion for ALUNBRIG® (brigatinib) to include patients with anaplastic lymphoma kinase-positive (ALK+) metastatic non-small cell lung cancer (NSCLC) who are tyrosine kinase inhibitor (TKI)-naive. ALUNBRIG is indicated for the treatment of adult patients with ALK+ metastatic NSCLC as detected by an […]
Astellas has announced the assignment of a product-specific, permanent J-code for PADCEV. The Centers for Medicare & Medicaid Services (CMS) released the July 2020 Quarterly Healthcare Common Procedural Coding System (HCPCS) File, which includes the designation of J9177 for PADCEV with the effective date of July 1, 2020.1 * Note that the product’s NDC code has been “zero-filled” […]
Novartis is pleased to announce that for dates of service on or after July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) has issued a product-specific J-code: J0791 for injection, crizanlizumab-tmca, 5 mg. The updated billing unit is 5 mg. The new and unique J-code replaces all previous HCPCS codes for ADAKVEO® (crizanlizumab-tmca) […]
US Food and Drug Administration (FDA) approved a new indication for LYNPARZA® (olaparib), as a treatment option for adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer (mCRPC) who have progressed following prior treatment with enzalutamide or abiraterone. Patients will be selected for therapy based on an […]
