Transcript 2015 Changes in cancer Coding instructions and reporting

2015 CHANGES IN REPORTING REQUIREMENTS AND
CANCER CODING INSTRUCTIONS
KENTUCKY CANCER REGISTRY SPRING TRAINING 2015
PRESENTED BY FRANCES ROSS
CHANGES IN CODING REQUIREMENTS AND
REPORTABILITY
CHANGES IN REPORTING REQUIREMENTS
 Pathologic stage data elements T, N, M and Stage Group are now
required to be coded (not merely ‘recommended’), according to
AJCC rules.
 However, blanks are allowed in the cT, cN, cM and pT, pN, pM
fields, but not in the cStage Group or pStage Group.
 Blanks are used when there is no information in the record; or
you do not know if an assessment was performed; or the criteria
for staging are not met, then T, N, and M are blank.
 See the Staging Video on Blanks vs. X on the AJCC web site:
http://cancerstaging.org/CSE/Registrar/Pages/Presentations.aspx
CHANGES IN REPORTABILITY
 Carcinoids of the appendix are now reportable as
8240/3
 Mature teratomas of the testes in adults are
malignant and reportable (9080/3). Mature teratoma
is not reportable for pre-pubescent males.
CHANGES IN REPORTABILITY
Pancreas
 Non-invasive mucinous cystic neoplasm (MCN) of
the pancreas with high grade dysplasia is
reportable. This term replaces mucinous
cystadenocarcinoma, non-invasive (8470/2)
CHANGES IN REPORTABILITY
Pancreas
 Cystic pancreatic endocrine neoplasm (CPEN) is
reportable. Assign code 8150/3, unless specified as
NET grade 1 (8240/3) or NET grade 2 (8249/3)
 Solid pseudopapillary neoplasm of the pancreas is
reportable as 8452/3
NEW DATA FIELDS
 Directly Coded
Summary Stage
NEW DATA FIELDS
 Treatment Plan – this will be a new text box under the
Text tab, to allow you to document what treatment was
planned if not yet given, or why certain treatments were
not planned or given
 Treatment Follow-back Needed– New field to flag
abstracts which need to be followed back for additional
therapy
CHANGES IN CODING INSTRUCTIONS
 Sex has two new valid codes
 Code 5 – Transsexual, natal male
 Code 6 – Transsexual, natal female
Code 4 remains Transsexual, NOS and may be used if the
gender at birth is unknown.
CHANGES IN CODING INSTRUCTIONS
 Non-definitive Surgery and Surgery at the Primary
Site
 If a needle biopsy precedes an excisional biopsy, even if no
tumor is found at the time of the surgery, both the needle biopsy
and the surgery must be recorded.
 Code the needle biopsy in the Non-definitive surgery field and
code the excision in the Surgery at Primary Site
CHANGES IN CODING INSTRUCTIONS
 Radiation therapy – Regional Dose: cGy
 Added instruction: For photon treatment, dosage is
reported in cGe units (Cobalt Grey Equivalent) rather
than cGy. You must multiply cGe by 100 to get cGy.
CHANGES IN CODING INSTRUCTIONS
 Other therapy
 Added instruction to code PUVA (psoralen and long-
wave ultraviolet radiation) as Code 1
UPDATES TO THE HEMATOPOIETIC DATABASE AND
MANUAL
 The Hematopoietic Database and Manual have been
updated for 2015; a conversion of data will occur
 Obsolete histologies may not be used for 2010+ cases
 Grade will be assigned to converted records, where a
defined grade exists
 Primary site will be assigned to current histologies
OBSOLETE HISTOLOGIES
 May not be used with diagnoses 2010 and later; an edit
check for this will be added.
 The most common of these are:
 9664, 9665, 9667 Hodgkin lymphoma, nodular sclerosis
9663
 9684 Malignant lymphoma, large B cell, immunoblastic
9680
 9805 Acute biphenotypic leukemia
9809
OBSOLETE HISTOLOGIES
 A conversion will be performed on any applicable cases in
your database with a diagnosis date of 2010 or later.
 The conversion may result in a schema change for some
cases. Detailed information on which cases need manual
review will be provided.
GRADE CONVERSION
 After the obsolete histologies are converted to
current histology codes, a grade will be assigned to
that case – either an applicable grade code, or a 9
will be assigned if there is no defined grade.
PRIMARY SITE CODES WILL BE CONVERTED FOR SELECT CASES
 For cases 2010 and later, these primary site codes
should no longer be used:
 Blood (C42.0), except for 9761/3 (Waldenstroms Macroglobulinemia)
 Reticuloendothelial system NOS (C42.3)
 Hematopoietic system, NOS (C42.4)
PRIMARY SITE CODES WILL BE CONVERTED FOR SELECT CASES
 Primary site will be reassigned for histologies for which
only one primary site code is applicable, e.g.,
leukemias must be coded (C42.1)
PRIMARY SITE CODES WILL BE CONVERTED FOR SELECT CASES
 The Primary site will be reassigned to Bone Marrow
(C42.1) for histologies which are:
 leukemias/lymphomas or
 histologies prominent in the bone marrow which had
been coded to C42.0, C42.3, or C42.4
PRIMARY SITE CODES WILL BE CONVERTED FOR SELECT CASES
 Manual review will be required for the remaining
histologies which had been coded to C42.0, C42.3, or
C42.4 (these are mostly lymphomas)
 These may require manual review of CS variables if the
newly assigned site results in a CS schema change
 Fewer than 15 cases will have to be reviewed; a list will be
placed on FES for each facility with case(s) to review
CONVERSION INFORMATION
 Details of the conversion may be found on the
SEER web site:
http://www.seer.cancer.gov/tools/heme/conversion.html
THE END
THANKS!