KEYTRUDA FOR ADVANCED ENDOMETRIAL CARCINOMA WITH LENVIMA® (lenvatinib)

The following codes as of September 2023 are provided as a reference and may be relevant when billing for KEYTRUDA and its administration. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of its use and for information on additional codes. Diagnosis codes should be selected only by a health care professional. You are solely responsible for determining the appropriate codes and for any action you take in billing.

When submitting a claim for KEYTRUDA, always verify coding requirements with the relevant payer. Coding requirements may vary by insurer or plan; please refer to the payer-specific policies to understand what may be covered.

Check with the relevant payer regarding guidance on which diagnoses they will recognize and the applicability of secondary codes. Health care professionals are solely responsible for selecting codes that appropriately reflect the patient’s diagnosis, the services rendered, and the applicable payers’ guidelines.

Providers should document the diagnosis with a sufficiently high degree of specificity based on the information available to enable the identification of the most appropriate code. Although CMS has said that an unspecified code may be appropriate in some cases, CMS has advised that you should always code with as much specificity as possible consistent with the clinical documentation.

Merck and its agents make no warranties concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. Merck cautions that payer-coding requirements vary and can frequently change, so it is important to regularly check with each payer or, where applicable, the Medicare Administrative Contractor as to payer-specific requirements. The use of this information does not guarantee payment or that any payment received will cover your costs.

For information about billing and coding products other than KEYTRUDA, please contact the manufacturer of the product or the applicable payer.

Indication

KEYTRUDA, in combination with LENVIMA, is indicated for the treatment of patients with advanced endometrial carcinoma that is pMMR as determined by an FDA-approved test or not MSI-H, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation.

FDA-Approved Dosing

The recommended dose of KEYTRUDA is 200 mg administered after dilution as an intravenous infusion over 30 minutes every 3 weeks or 400 mg administered after dilution as an intravenous infusion over 30 minutes every 6 weeks in combination with LENVIMA 20 mg orally once daily until disease progression, unacceptable toxicity, or for KEYTRUDA, up to 24 months.

See the Prescribing Information for LENVIMA for additional recommended dosing information.

See full Prescribing Information for preparation and administration instructions and dosage modifications for adverse reactions.

Possible relevant diagnosis codes for advanced endometrial carcinoma

Learn more about each diagnosis code and descriptor by selecting from the series options below.

 

C54: Malignant Neoplasm of Corpus Uteri4

    ICD-10-CM CODE DESCRIPTOR
    C54.0 Malignant neoplasm of isthmus uteri
    • Malignant neoplasm of lower uterine segment
    C54.1 Malignant neoplasm of endometrium
    C54.2 Malignant neoplasm of myometrium
    C54.3 Malignant neoplasm of fundus uteri
    C54.8 Malignant neoplasm of overlapping sites of corpus uteri
    C54.9 Malignant neoplasm of corpus uteri, unspecified

C55: Malignant Neoplasm of Uterus, Part Unspecified4

ICD-10-CM CODE DESCRIPTOR
C55 Malignant neoplasm of uterus, part unspecified

C57: Malignant Neoplasm of Other and Unspecified Female Genital Organs4

ICD-10-CM CODE DESCRIPTOR
C57.8 Malignant neoplasm of overlapping sites of female genital organs
  • Primary malignant neoplasm of two or more contiguous sites of the female genital organs whose point of origin cannot be determined
  • Primary tubo-ovarian malignant neoplasm whose point of origin cannot be determined
  • Primary utero-ovarian malignant neoplasm whose point of origin cannot be determined