Other Services HCPCS Code range M1146-M1425

Grade 2 or above diarrhea and/or grade 2 or above colitis

Patients not eligible due to pre-existing inflammatory bowel disease (ibd) (e.g., ulcerative colitis, crohn's disease)

Documentation of immune checkpoint inhibitor therapy held and corticosteroids or immunosuppressants prescribed or administered

Documentation of medical reason(s) for not prescribing or administering corticosteroid or immunosuppressant treatment (e.g., allergy, intolerance, infectious etiology, pancreatic insufficiency, hyperthyroidism, prior bowel surgical interventions, celiac disease, receiving other medication, awaiting diagnostic workup results for alternative etiologies, other medical reasons/contraindication)

Documentation of immune checkpoint inhibitor therapy not held and/or corticosteroids or immunosuppressants prescribed or administered was not performed, reason not given

Patients who have an order for or are receiving hospice or palliative care

Patients with a diagnosis of end stage renal disease (esrd)

Patients with a diagnosis of chronic kidney disease (ckd) stage 5

Documentation of a kidney health evaluation defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr) performed

Documentation of a kidney health evaluation was not performed or defined by an estimated glomerular filtration rate (egfr) and urine albumin-creatinine ratio (uacr)