DRUGS
TREATMENTS
DISEASE TYPES
Authorizations
POTPOURRI
100

Also known as Abraxane, this is the J-code for albumin-bound paclitaxel.

What is J9264?

100

This form of treatment uses medicines or drugs to treat cancer.

What is chemotherapy?

100

This type of cancer suppresses the production of red blood cells.

What is leukemia?

100

This drug category may require prior authorization with insurances; however patients are allowed to start these drugs at MSK while auth is pending.

What are non-restricted drugs?

100

This person is the current CEO of MSK.

Who is Dr. Selwyn Vickers?

200

This drug is used to treat neutropenia after a cycle of chemotherapy.

What is Pegfilgrastim?

200

These treatment options give patients access to experimental medicines that may not yet be FDA/NCCN approved.

What are clinical trials?

200

This type of cancer starts in certain types of skin cells.

What is melanoma?

200

These two entities dictate approved indications for cancer medications for Medicare/Medicaid-insured patients. 

What are the FDA and NCCN?

200

This is the month in which most commercial health plans renew their policies.

What is January?

300

This drug is the preferred product for IVIG at MSK.

What is Gamunex-C?

300

This type of treatment uses high-energy particles or waves to destroy or damage cancer cells.

What is radiation therapy?

300

This cancer is not usually associated with men because many people do not realize that men have the same kind of tissue as women.

What is breast cancer?

300

This web portal is used to submit chemo PA requests for Fidelis, Emblem, and Wellcare members.

What is Evolent?

300

This person has worked in several roles in PFS, including Specialist, Patient Financial Navigator, and Group Lead

Who is Meghan Taddeo?

400

This drug has a standing admin clear workflow if a patient has an allergic reaction to Paclitaxel.

What is Abraxane?

400

A procedure that can stop some chemotherapy drugs from affecting your hair follicles.

What is Scalp Cooling?

400

This is what the “ST” in STGI stands for.

What is solid tumor?

400

This team initiates manufacturer assistance program applications once a Financial Assistance tracker is created by PFS.

What is the PFS CoPay Assistance team?

400

This person is an MD in the STGI service and also the Chemo Medical Director at MSK.

Who is Dr. Leonard Saltz?

500

These are the two brand names for denosumab, which also have the same J-code.

What are Xgeva and Prolia?

500

This type of therapy indicates that the patient has already had surgery before receiving chemo.

What is adjuvant chemotherapy?

500

This Medical Oncology Service is focused the treatment of conditions affecting the chest cavity and its organs.

What is Thoracic Medicine?

500

This is the referral status and status reason used when a patient is admin cleared to start a drug while auth is pending with the insurance.

What is Authorized + Medically Cleared (Auth Pending)?

500

This insurance may approve 1-3 cycles of certain chemotherapies for onsite administration at MSK, and then transition patients to home infusion.

Horizon BCBS