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HCPCS codes change their meaning over time


(Dmytry Dymshyts) #1

@MFernandez-Chas
discovered that HCPCS codes have the wrong mapping

The HCPCS codes for cancer therapeutic drugs Kymriah (Q2040, Q2042) and Yescarta (Q2041) seem to be mapped to non-cancer drugs. Here is the current mapping with the corresponding description:

HCPCS Q2040
OMOP Concept ID: 35605867
OMOP Concept Name: Botulinum Toxin Type A Injection

HCPCS Q2042
OMOP Concept ID: 36249937
OMOP Concept Name: 17-alpha-Hydroxyprogesterone Injection

HCPCS Q2041
OMOP Concept ID: 41085967
OMOP Concept Name: von Willebrand factor 1 UNT Injectable Solution

The thing is that these codes changed their meaning over time,
for example:
Q2042 was “Injection, hydroxyprogesterone caproate, 1 mg” till 2017-11-05,
but beginning from 2019-01-01 it becomes “Tisagenlecleucel, up to 600 million car-positive viable t cells, including leukapheresis and dose preparation procedures, per therapeutic dose”

So, we can’t just change the mapping, because if the Q2042 concept exists in a patient data before 2017, the mapping to “hydroxyprogesterone caproate” is correct.

@Christian_Reich, @aostropolets,
Thoughts?


Vaccines standard - CVX or RxNorm?
(Anna Ostropolets) #2

Yep, this is a feature of NDC that pops up. An obvious and discussed approach is to use valid_end_date, valid_start_date to separate those 2 codes. To implement this logic, we need a reliable source of codes, names, and their valid dates. This is why there is an ongoing collection of NDC codes from different sources so that these codes can be validated and inserted into the vocabulary.
The corresponding forum thread is here: Missing NDCs remote studies
so everybody is more than welcome to submit their data there.


(Dmytry Dymshyts) #3

So, we concatenate alid_end_date, valid_start_date, concept_code to distinguish these concepts
or
change the whole logic allowing to exist two concepts with the same concept codes but different dates
?
Sorry, I can’t see here
Missing NDCs remote studies
where the exact format is discussed


(Anna Ostropolets) #4

You are all over the place guys :slight_smile:


Missing NDC and HCPCS in OMOP and Athena and so on.
Concept code and dates, correct


(Dmytry Dymshyts) #5

Just talked to @aostropolets
So, yes, we are going to allow duplicated concept_codes with different start / end dates.
So, I’ll collect more information about HCPCS changes over time


(Margarita Fernandez-Chas) #6

Thank you. That would be very helpful. I hope these changes can be made sometime soon. Could it be possible to receive a notification when this happens?


(Dmytry Dymshyts) #7

Sure, I’ll notify you.


(Matt Stagg) #8

Thank you everyone for your help. Just following up with this. Any progress with this mapping issue of Kymriah and Yescarta HCPCS codes?


(Dmytry Dymshyts) #9

Not yet.
Seems I hurried with this

This requires too many changes. So we need to think twice about this idea or come up with other ideas.


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