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Common Errors in the Central Registry. TRAM Educational Conference September 19, 2014 Meritus Medical Center. Common Errors in the Central Registry. Objectives: - Discuss the Central Registry practice for reviews - Review common errors seen in the Central Registry
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Common Errors in the Central Registry TRAM Educational Conference September 19, 2014 Meritus Medical Center
Common Errors in the Central Registry Objectives: - Discuss the Central Registry practice for reviews - Review common errors seen in the Central Registry - Focus on FORDS standards for palliative care and first course of treatment - Update from the MCR
Common Errors in the Central Registry Audit Process MCR 5 year cycle Completeness Re-abstraction
Common Errors in the Central Registry Audit Process NPCR – Data Quality Evaluation 5 year cycle Visual Editing (Text to Code) Re-consolidation
Common Errors in the Central Registry Top Primary Sites Breast Lung Colon Rectosigmoid Colon Rectum Uterus Prostate
Common Errors in the Central Registry Grade most frequent error
Common Errors in the Central Registry Conversion issues FIGO Grade Coding Grade from a metastatic site Following Rule G in the ICD-O-3 manual
Common Errors in the Central Registry If the information is not in FORDS refer to the SEER Coding and Staging Manual Appendix C Grade Conversion Table for Invasive Carcinoma of the Breast
Common Errors in the Central Registry For Breast In-Situ DCIS Grade Conversion Table
Common Errors in the Central Registry The FIGO grading system for carcinomas of the uterine corpus is only officially designated for endometrioid carcinomas and is based on architectural features as follows: Grade 1 5% or less nonsquamous solid growth pattern Grade 2 6% to 50% nonsquamous solid growth pattern Grade 3 > 50% nonsquamous solid growth pattern Ref: CAP Protocols for Cancer Reporting 2012
Common Errors in the Central Registry Rule G. Grading or differentiation code: Assign the highest grade or differentiation code described in the diagnostic statement. “Grade High/Stage Low” DO NOT code grade from a metastatic site, use code 9. Ref: ICD-O-3 Coding Manual page 21
Common Errors in the Central Registry Date of First Surgical Procedure Date of First Surgical Procedure is the date the first Surgical Procedure of Primary Site, Scope of Regional Lymph Node Surgery, or Surgical Procedure/Other Site is performed as part of first course of treatment. Ref: FORDS 2013 page 21
Common Errors in the Central Registry The date in this item may be the same as that in Date of Most Definitive Surgical Resection of the Primary Site (NAACCR Item #3170), if the patient received only one surgical procedure and it was a resection of the primary site. If surgery is the first or only treatment administered to the patient, then the date of surgery should be the same as the date entered into the item Date of First Course Treatment (NAACCR Item #1270).
Common Errors in the Central Registry Palliative Care and Date First Course of Treatment Surgical procedures, radiation therapy, or systemic therapy provided to prolong the patient's life by controlling symptoms, to alleviate pain, or to make the patient comfortable should be coded palliative care and as first course therapy if that procedure removes or modifies either primary or metastatic malignant tissue.
Common Errors in the Central Registry Examples for Code 0: No Palliative Care is provided; diagnosed at autopsy Source: FORDS:Facility Oncology Registry Data Standards: Revised for 2012
Common Errors in the Central Registry Examples for Code 1: Surgery (which may involve a bypass procedure) to alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made. Source: FORDS:Facility Oncology Registry Data Standards: Revised for 2012
Common Errors in the Central Registry Examples for Code 2: RT to alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made.
Common Errors in the Central Registry Examples for Code 3: Chemo, Hormonal or other systemic drugs to alleviate symptoms, but no attempt to diagnose, stage, or treat the primary tumor is made.
Common Errors in the Central Registry Examples for Code 4: Patient received or was referred for pain management w/ no other palliative care.
Common Errors in the Central Registry Examples for Code 5, 6, and 7: Any combination of 1, 2, and/or 3 w/ or without 4 or no info available.
Common Errors in the Central Registry Regional Nodes Positive/Regional Nodes Examined 00/98 vs. 98/00 98 No nodes examined for RN Positive 00 No nodes examined for RN Examined
Common Errors in the Central Registry What are regional nodes???
Common Errors in the Central Registry Use of code 95. Use code 95 when the only procedure for regional lymph nodes is a needle aspiration (cytology) or core biopsy (tissue). Example: Patient with esophageal cancer. Enlarged mid-esophageal node found on CT scan, which is aspirated and found to be positive. Patient undergoes radiation therapy and no surgery. Code Regional Nodes Positive as 95 and Regional Nodes Examined as 95.
Common Errors in the Central Registry Lymph node biopsy. If a lymph node biopsy was performed, code the number of nodes removed, if known. If the number of nodes removed by biopsy is not known, use code 96. Definition of “sampling” (code 96). A lymph node “sampling” is removal of a limited number of lymph nodes. Other terms for removal of a limited number of nodes include lymph node biopsy, berry picking, sentinel lymph node procedure, sentinel node biopsy, selective dissection. Use code 96 when a limited number of nodes are removed but the number is unknown. (Less than or equal to 4)
Common Errors in the Central Registry Multiple lymph node procedures. If both a lymph node sampling and a lymph node dissection are performed and the total number of lymph nodes examined is unknown, use code 97.
Common Errors in the Central Registry Other issues: - Dates for treatment fields not in text - 00 vs. 99 when text indicates ‘none’ or the treatment is not indicated for the diagnosis - 998 vs. 999 in the CS SSF fields - lack of adequate text to validate coding
Common Errors in the Central Registry Questions?
MCR Updates Death and Lab Only Follow-back Disease Indices and Accession Registers Submission Monitoring
