Category Archives: Industry Insights

  Below is the transcript from our On-Demand Micro-Webinar: Vaccine Coding Challenges Powered by Laura:    Good day, welcome, and thanks for joining us. Today we’d like to help you by providing a quick brush up on vaccine coding. I’m Laura, Clinical Informatics Pharmacist for RJ Health, and joining me today is Chris Webb who is our […]

FDA Approval: 10/5/2018 Familial amyloid polyneuropathy (FAP, also called transthyretin amyloidosis) is a hereditary neurodegenerative disease that is characterized by the accumulation and deposition of the transthyretin protein (TTR) in the tissues and peripheral nervous system, and often causes pain, muscle weakness, and autonomic dysfunction. Eventually, the disease progresses into a sensory and motor polyneuropathy. […]

New Drug Overview – elapegademase-lvlr (Revcovi™) On October 5, 2018, the U.S. Food and Drug Administration (FDA) approved elapegademase-lvlr (Revcovi™) for the treatment of adenosine deaminase severe combined immune deficiency (ADA-SCID) in pediatric and adult patients.  (ADA-SCID) is a rare genetic disorder that primarily affects infants and young children and is fatal if left untreated. […]

FDA Approval: 9/28/2018 Cutaneous squamous cell carcinoma (CSCC) is the second most deadly skin cancer following melanoma. CSCC leads to about 3,900 to 8,800 deaths per year in the United States. Prior to Cemiplimab approval, there were no FDA-approved treatments for advanced CSCC which is metastatic or where surgery is not an option. The rarity […]

New Drug Overview – galcanezumab-gnlm (Emgality™) On September 27, 2018, the U.S. Food and Drug Administration (FDA) approved galcanezumab-gnlm (Emgality™) for the preventive treatment of migraine in adults.  Galcanezumab-gnlm is the third calcitonin-gene related peptide antagonist to be approved for this indication this year after fremanezumab-vfrm and erenumab-aooe, approved on 9/14 and 5/17 respectively.  According […]

INSIDE THIS ISSUE Code Updates: Update – New Q-Code Effective October 1, 2018 and July 12, 2018 Reminder – New C-Codes for Hospital OPPS use Effective October 1, 2018  CMS News: Medicare Influenza Vaccine Pricing 2018-2019 Season NEW Influenza CPT® Code 90689 Effective January 1, 2019  Drug Reimbursement Code Price Updates  Drugs/Devices: New Clinical and […]

Each year there are dozens of new drugs (56 in 2018) and new CMS HCPCS assignments (38 in January 2018), as well as hundreds of new indications approved. This is in addition to the ongoing updates in coding assignments, pricing, generic entries and more. Consider that the average cost for a medically covered drug is […]

Many medically covered drugs are costly, and processing errors can have significant implications. By 2020, it is estimated that more than half of specialty drug claim costs will be submitted through the medical benefit. Join Wendy Sullivan, Director of Data Informatics, on October 11th, 2pm EST, as she walks through the common issues and solutions […]

In September there were a total of six new drug approvals by the FDA we deemed specific to the specialty market. In addition, there were two supplemental drug approvals. The FDA had assigned six new products for review. Finally, there was one complete response letter with no current data on expected resubmission date. Drugs included […]

FDA Approval: 9/14/18 Migraine is a debilitating disorder that affects millions of people in the United States. Migraine can affect individuals in a way that deprives them of their normal, daily activities, and often results in pain, physical impairment, lost productivity, and increased financial cost. Fremanezumab-vfrm, developed by Teva Pharmaceutical Industries Ltd., is a fully […]