Hello,

I am requesting the inclusion of the RxNorm code for the newly available Tenecteplase 25 mg vial in the value set with OID 2.16.840.1.113883.3.117.1.7.1.226.

• Clinical rationale:
• Tenecteplase is now available in a 25 mg vial, which aligns with the maximum recommended dosage for ischemic stroke.
• Previously, only 50–100 mg vials were available, which posed a risk of inadvertent overdosing if the entire vial was administered.
• The 25 mg vial was introduced specifically to improve patient safety and reduce dosing errors.

• Measure impact:

• Because the RxNorm code for the 25 mg vial is not currently included in the value set, patients who received this safer vial are not being correctly excluded from the denominator.
• This results in inaccurate measure reporting and penalizes organizations for adopting safer practices.

Request:

1. Please add the RxNorm code for the Tenecteplase 25 mg vial to the value set.
2. Confirm whether this update will apply retrospectively so that patients treated with the 25 mg vial are correctly excluded from the denominator in past reporting periods.

Thank you for your attention to this matter and for supporting accurate, safety‑aligned measure reporting.

Sincerely,

Becky Grigsby