Drug Therapy Requiring Intensive Monitoring for Toxicity

Question:

When auditing MDM, is there a list of drugs that are considered “drug therapy requiring intensive monitoring for toxicity?”

Answer:

Not from the AMA.

Here’s the definition:

“Drug therapy requiring intensive monitoring for toxicity: A drug that requires intensive monitoring is a therapeutic agent that has the potential to cause serious morbidity or death. The monitoring is performed for assessment of these adverse effects and not primarily for assessment of therapeutic efficacy. The monitoring should be that which is generally accepted practice for the agent, but may be patient specific in some cases. Intensive monitoring may be long-term or short term. Long-term intensive monitoring is not performed  less than quarterly. The monitoring may be performed with a lab test, a physiologic test or imaging. Monitoring by history or examination does not qualify. The monitoring affects the level of MDM  in an encounter in which it is considered in the management of the patient. An example may be monitoring for cytopenia in the use of an antineoplastic agent between dose cycles.  Examples of monitoring that do not qualify include monitoring glucose levels during insulin therapy, as the primary reason is the therapeutic effect (unless severe hypoglycemia is a current significant  concern); or annula electrolytes and renal function for a patient on a diuretic, as the frequency does not meet the threshold.”

• The condition being monitored must be treated at that encounter to qualify
• Differentiate between therapeutic efficacy and dosing and the risk of morbidity or death.

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