Bo o t Ca mp 2014 3/ 6/ 14 NAACCR 2013 2014 Webinar Series - PDF document

Bo o t Ca mp 2014 3/ 6/ 14 NAACCR 2013 ‐ 2014 Webinar Series Abstracting & Coding Boot Camp March 6, 2014 Q&A  Please submit all questions concerning webinar content through the Q&A panel. Reminder:  If you have participants watching this webinar at your site, please collect their names and emails.  We will be distributing a Q&A document in about one week. This document will fully answer questions asked during the webinar and will contain any corrections that we may discover after the webinar. Fabulous Prizes 3 NAACCR 2013-2014 We b ina r Se rie s 1

Bo o t Ca mp 2014 3/ 6/ 14 2014  Hematopoietic & Lymphoid Neoplasm Database and Manual  Updated 1/17/14  Provides data collection rules for hematopoietic and lymphoid neoplasms diagnosed 1/1/2010 and later  http://seer.cancer.gov/tools/heme/ 4 Quiz 1 ‐ Terminology and Anatomy 5 Instructions for Coding Grade 1/1/2014 and Forward NAACCR 2013-2014 We b ina r Se rie s 2

Bo o t Ca mp 2014 3/ 6/ 14 Grade  Coding grade has been complicated by  Site ‐ specific grading systems  Differing instructions in FORDS and SEER PCSM  Revised instructions  http://seer.cancer.gov/tools/grade/  Are applicable for cases diagnosed 1/1/2014 and forward  Will be incorporated in 2014 FORDS and 2014 SEER PCSM Grade Alte rna te Na me Ite m # L e ng th Sourc e of Sta nda rd Gra de , Diffe re ntia tio n, o r Ce ll 440 1 SE E R/ Co C L ine a g e Indic a to r (SE E R/ CCCR) Gra de / Diffe re ntia tio n (Co C) Coding Grade for Hematopoietic & Lymphoid Neoplasms  Cell indicator describes lineage or phenotype of cell  Codes 5 ‐ 8 used only for hematopoietic & lymphoid neoplasms T e rminolog y Gra de Code T -c e ll; T -pre c urso r 5 B-c e ll; Pre -B; B-pre c urso r 6 Null c e ll; No n T -no n B 7 NK c e ll (na tura l kille r c e ll) 8 Gra de unkno wn, no t sta te d, o r no t a pplic a b le 9 NAACCR 2013-2014 We b ina r Se rie s 3

Bo o t Ca mp 2014 3/ 6/ 14 Coding Grade for Hematopoietic & Lymphoid Neoplasms 1. Determine histology using Hematopoietic & Lymphoid Neoplasm Manual 2. Apply the grade of tumor rules to determine the cell indicator for the histology Coding Grade for Solid Tumors  Grade measures resemblance of the tumor cells to organ of origin  Codes 1 ‐ 4 and 9  3 systems  2 ‐ grade  3 ‐ grade  4 ‐ grade Coding Grade for Solid Tumors 1. Code grade prior to neoadjuvant treatment even if unknown 2. Code grade from primary tumor only 3. Code grade for histologic terms that imply grade  Carcinoma, undifferentiated (8020/34)  Follicular adenocarcinoma, well differentiated (8331/31)  See Instructions document for entire list NAACCR 2013-2014 We b ina r Se rie s 4

Bo o t Ca mp 2014 3/ 6/ 14 Coding Grade for Solid Tumors 4. In situ a. Code grade for in situ tumor if given b. Code grade for invasive portion of tumor, even if unknown, for tumors with both in situ and invasive components 5. Code highest grade from applicable system if there is more than 1 grade even if only a focus; priority order for applicable systems a. Special grade systems listed in #6 b. Differentiation per #7 c. Nuclear grade per #7 d. Code it if not clear if differentiation or nuclear grade e. Terminology per #8 Coding Grade for Solid Tumors 6. Use special grade systems first CS Sc he ma Spe c ia l Gra de Syste m Bre a st No tting ha m o r BR Sc o re / Gra de (SSF 7) Pro sta te Gle a so n’ s Sc o re o n Bio psy/ T URP (SSF 8) Pro sta te Gle a so n’ s Sc o re o n Pro sta te c to my/ Auto psy (SSF 10) He a rt, Me dia stinum Gra de fo r Sa rc o ma s (SSF 1) Pe rito ne um Gra de fo r Sa rc o ma s (SSF 1) Re tro pe rito ne um Gra de fo r Sa rc o ma s (SSF 1) So ft T issue Gra de fo r Sa rc o ma s (SSF 1) K idne y Pa re nc hyma F uhrma n Nuc le a r Gra de (SSF 6) Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system a. Two ‐ grade system NAACCR 2013-2014 We b ina r Se rie s 5

Bo o t Ca mp 2014 3/ 6/ 14 Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system b. Three ‐ grade system Coding Grade for Solid Tumors 7. Use two ‐ , three ‐ , or four ‐ grade system c. Four ‐ grade system Coding Grade for Solid Tumors 8. Terminology De sc ription Gra de Code Exc e ption for Bre a st & Prosta te Diffe re ntia te d NOS I 1 We ll diffe re ntia te d I 1 Only sta te d a s ‘ Gra de I ’ I 1 NAACCR 2013-2014 We b ina r Se rie s 6

Bo o t Ca mp 2014 3/ 6/ 14 De sc ription Gra de Code Exc e ption for Bre a st & Prosta te F a irly we ll diffe re ntia te d I I 2 I nte rme dia te diffe re ntia tio n I I 2 L o w g ra de I -I I 2 1 Mid diffe re ntia te d I I 2 Mo de ra te ly diffe re ntia te d I I 2 Mo de ra te ly we ll diffe re ntia te d I I 2 Pa rtia lly diffe re ntia te d I I 2 Pa rtia lly we ll diffe re ntia te d I -I I 2 1 Re la tive ly o r g e ne ra lly we ll I I 2 diffe re ntia te d Only sta te d a s ‘ Gra de I I ’ I I 2 De sc ription Gra de Code Exc e ption for Bre a st & Prosta te Me dium g ra de , inte rme dia te I I -I I I 3 2 g ra de Mo de ra te ly po o rly diffe re ntia te d I I I 3 Mo de ra te ly undiffe re ntia te d I I I 3 Po o rly diffe re ntia te d I I I 3 Re la tive ly po o rly diffe re ntia te d I I I 3 Re la tive ly undiffe re ntia te d I I I 3 Slig htly diffe re ntia te d I I I 3 De diffe re ntia te d I I I 3 Only sta te d a s ‘ Gra de I I I ’ I I I 3 Coding Grade for Solid Tumors De sc ription Gra de Code Exc e ption for Bre a st & Prosta te Hig h g ra de I I I -I V 4 3 Undiffe re ntia te d, a na pla stic , no t I V 4 diffe re ntia te d Only sta te d a s ‘ Gra de I V’ I V 4 No n-hig h g ra de 9 NAACCR 2013-2014 We b ina r Se rie s 7

Bo o t Ca mp 2014 3/ 6/ 14 Coding Grade for Solid Tumors 9. If no description fits or grade is unknown prior to neoadjuvant therapy, code as 9 (unknown) Special Grade System Rules  Breast  Use Bloom Richardson (BR) or Nottingham score/grade to code grade based on SSF7  Code grade using the following priority  BR scores 3 ‐ 9  BR grade (low, intermediate, high)  Do not use the table if only grade 1 ‐ 4 with no information on score and unclear if it is Nottingham or BR grade  Code highest score if multiple scores are reported De sc ription CS Gra de Code Code Sc o re o f 3 030 1 Sc o re o f 4 040 1 Sc o re o f 5 050 1 Sc o re o f 6 060 2 Sc o re o f 7 070 2 Sc o re o f 8 080 3 Sc o re o f 9 090 3 L o w g ra de , BR g ra de 1, sc o re no t g ive n 110 1 Me dium (inte rme dia te ) g ra de , BR g ra de 2, sc o re no t 120 2 g ive n Hig h g ra de , BR g ra de 3, sc o re no t g ive n 130 3 24 NAACCR 2013-2014 We b ina r Se rie s 8

Bo o t Ca mp 2014 3/ 6/ 14 Special Grade System Rules  Kidney parenchyma  Use Fuhrman Nuclear Grade to code grade based on SSF6  Do NOT use for renal pelvis De sc ription CS Code Gra de Code Gra de 1 010 1 Gra de 2 020 2 Gra de 3 030 3 Gra de 4 040 4 Special Grade System Rules  Soft Tissue includes soft tissue, heart, mediastinum, peritoneum, and retroperitoneum  Use Grade for Sarcomas to code grade based on SSF1  Record grade from any three ‐ grade sarcoma grading system  Code terminology using table from #8 Special Grade System Rules  Soft tissue De sc ription CS Code Gra de Code Spe c ifie d a s g ra de 1 [o f 3] 010 2 Spe c ifie d a s g ra de 2 [o f 3] 020 3 Spe c ifie d a s g ra de 3 [o f 3] 030 4 Gra de sta te d a s lo w g ra de NOS 100 2 Gra de sta te d a s hig h g ra de NOS 200 4 NAACCR 2013-2014 We b ina r Se rie s 9

Bo o t Ca mp 2014 3/ 6/ 14 Special Grade System Rules  Prostate  Use highest Gleason score from biopsy/TURP (SSF8) or prostatectomy/autopsy (SSF10) Special Grade System Rules: Prostate AJCC 7 th Gle a son CS Code Gra de Code SE E R 2003- Sc ore 2013 2 002 1 G1 G1 3 003 1 G1 G1 4 004 1 G1 G1 5 005 1 G1 G2 6 006 1 G1 G2 7 007 2 G2 G3 8 008 3 G3 G3 9 009 3 G3 G3 10 010 3 G3 G3 Quiz 2 ‐ Data Items 30 NAACCR 2013-2014 We b ina r Se rie s 10

Bo o t Ca mp 2014 3/ 6/ 14 Text in the Cancer Abstract: What & Why 31 Text  Narrative justification of coded information  Tells the story of patient’s cancer in language that supports the codes  Clarifies difficult coding decisions  Why an edit was overridden  Describe why information is missing or unknown  Explains anything unusual about the case  Needs to be succinct, complete, and dated 32 Text  In the central registry  Used to reconcile duplicate cases  Consolidate cases  Confirm accuracy of coded data  Quality Control  Visual Editing/Review  Compare text to coded data  Recoding audit  Recode an abstract using provided text 33 NAACCR 2013-2014 We b ina r Se rie s 11