Download Mini-Update - January 2013

MCR MINI-UPDATE JANUARY 2013
Fellow Registrars,
The year 2013 is upon us! Fortunately, as you will see below, it will not bring many changes
from the standard setters. Hopefully this will give us all a chance to get caught up and catch our
breath. Please share this with others who do not receive it. Let me know if you have any
questions.
2013 CHANGES AT MCR
Casefinding List
Review of the facility Medical Record Disease Index (MRDI) is essential to accomplishing complete
cancer casefinding (see MCR Manual Chapter 2 for details). In the past, MCR has customized its own
tool based on the SEER published list. This year, the 2013 SEER tool is provided directly to assist you in
determining which codes to include in your facility’s MRDI: http://seer.cancer.gov/tools/casefinding/
The expanded version accommodates either ICD-9-CM or ICD-10_CM codes. MCR recommends that
you use the codes on the Comprehensive section of the list and add as many codes from the
Supplemental section as prove useful at your facility. Please share your decisions with the
programmers who help you sift through billing codes at your facility so that it can be implemented with
2013 casefinding.
Required Data Elements
The table of MCR Required Data Elements has been updated for 2013 and posted to the MCR website.
It will be provided to your software vendor for incorporation into NAACCR v13 software upgrades and
database conversions. Changes are noted on the posted table and include:
 First Course Calc Method - this field has been retired by NAACCR; look for more specific details
on this in a future update.
 There are some new data items for recording state and country separately as part of a
standardization/interoperability initiative. Fortunately, vendors are being encouraged to have
country automatically fill based on the state or province entry. Historic codes related to Place of
Birth and Death will be replaced during software conversion. Look-up tables will provide codes
for the new fields.
 The Ambiguous Terminology field is no longer required for new cases, although the ambiguous
terms themselves remain important for determining case and primary reportability.
 RX Date data items changed in name only so that closely-related items would be adjacent in
alphabetical listings.
 Unusual Follow-up Method is now a 2 digit field to allow additional codes needed by central
registries.
 There are no changes to Missouri-specific fields.
Upcoming Edits and Conversions
The NAACCR edit metafile v13 was released in mid-December. I will customize it for Missouri and
forward it to the hospital registry software vendors to incorporate into their upgrades that you will use
in converting your database to NAACCR v13 during 2013. I will provide details on the edit metafile and
timing announcements regarding our conversion of Web Plus to NAACCR v13 layout in a future monthly
update. Our central registry software vendor currently anticipates that conversion of the MCR database
will occur no earlier than April.
MCR Manual
The MCR Abstract Coding Manual will be revised this winter now that FORDS 2013 was recently
published. Watch for an announcement in a future monthly update.
EDUCATION
NAACCR Webinars – are trainings that are held here in our offices the first Thursday of each month for
3-4 hours, which typically begin at 8am and are presented by NAACCR Staff. MCR-ARC is only a host
site for the telecast of the webinar.
 January 10, 2013 - Collecting Cancer Data: Bone and Soft Tissue
Recorded Webinars are now available to view. Request Access Now! Check out our Education and
Training page to find out how you can receive access to previously recorded NAACCR Webinars including
Uterus, Stomach and Esophagus, Pharynx.
Live Meetings - are trainings which are viewed from your computer on the second Wednesday of each
month, are usually one hour long, begin at 10am and are presented by MCR-ARC Staff.

January 9, 2013 - Surgery Coding for Skin Primaries, by Angela Martin.

February 13, 2013 - Multiple Primary and Histology General Rules Overview, by Deb Smith
As always, to register for any of our educational opportunities, contact Shari El Shoubasi at
[email protected] or 1-866-240-8809. Please be sure to clarify which session you will be
attending when you register.
ABSTRACTING TIPS
Abstracting Tip – Cervix
Histology code 8384 (Adenocarcinoma, endocervical type) should not be used to code Adenocarcinoma,
NOS that arises in the cervix. Adenocarcinoma, endocervical type is a specific histologic type which is
coded only when it is a part of the final pathologic diagnosis. Use histology code 8140 for
Adenocarcinoma, NOS that arises in the cervix.
Abstracting Tip – Endometriod vs. Endometrial
When abstracting histologic type for endometrial primaries, be careful not to confuse the terminology,
“endometrioid” adenocarcinoma and “endometrial” adenocarcinoma. “Endometrioid” refers to a
specific subtype of adenocarcinoma, while “endometrial” adenocarcinoma signifies adenocarcinoma,
NOS arising from the endometrium. Please be certain to use the correct term when documenting the
pathology diagnosis in your text.
Abstracting Tip – Overlapping Sites
When a primary tumor extends to occupy adjacent subsites, remember to code the primary site as the
subsite in which the tumor originated rather than assign an “overlapping sites” code. The .8 subsite
code should be used only when the primary tumor involves adjacent sites and it’s not possible to
determine its point of origin. In your text, please name the overlapping sites represented by the
primary site code rather than merely enter “overlapping sites.”
STANDARD SETTER NEWS
CoC Update on Assigning Class of Case in the Age of Mergers
http://newsmanager.commpartners.com/acscoc/issues/2012-12-07/7.html
CODING UPDATES
There will be no 2013 changes for Collaborative Stage v2.04 or Multiple Primary & Histology Coding
Rules! Next changes for them are scheduled for 2014 and 2015, respectively. FORDS 2013 was just
released and is available at http://www.facs.org/cancer/coc/fordsmanual.html. Until you begin
abstracting 2013 cases and upgrade to NAACCR v13, it is good to check to assure that you have the most
current versions of coding instructions for 2012:
FORDS
If you need to reference FORDS, be sure you have downloaded FORDS 2012c which is updated through
6/29/12.
Appendix C documents the changes since 1/1/12:
Class of Case, second example code corrected to 13
Type of Multiple Tumors Reported as One Primary, typo codes 13 and 14 corrected to 20 and 30
Multiplicty Counter – code 88 added for C80.9
Radiation/Surgery Sequence and Systemic Surgery Sequence, code 4 definitions corrected, see FORDS
Appendix B Breast Surgery code note about contralateral cancers corrected to specify either code 41 or
51 in cases with contralateral primaries.
MP/H
The Multiple Primary and Histology Manual was updated 8/24/12. See an outline of the changes at:
http://seer.cancer.gov/tools/mphrules/revisions.html
Hematopoietic and Lymphoid Neoplasm Rules
Last released in April 2012, the web version is recommended for automatic access to updates. The
stand alone is currently dated 5/23/2012.
SEER Rx Interactive Drug Database
Last released in May 2012, the web version is recommended for automatic access to updates. The stand
alone is currently dated 5/7/2012.
Occupation and Industry
Reporting Facilities should have reviewed the pamphlet at http://www/cdc/gov/niosh/docs/2011-173
and be applying these principles to text they enter on abstracts.
Answers to Coding Dilemmas in CSv0204
Do you have a case where none of the CS codes seems right for your scenario? It is probably a known
issue, and one that the CS team is addressing for version 02.05. In the meantime, CS has developed a
document to help you, and it is posted on the home page at
http://www.cancerstaging.org/cstage/CSv0204-support-known.pdf The “CSv0204 Support for Identified
Issues” is an important resource. This provides registrars coding guidelines for the key issues identified
in the current version, 0204, that will be fixed in the next release. The list is brief, as we try to keep it to
the most important issues, or those affecting a large number of cases. If your issue isn’t there, please
use the search feature in the CAnswer Forum to find the guidance you need. If you topic has not yet
been addressed, you may submit it the CAnswer Forum for assistance.
CS Website
Check out the recently added education presentations page
http://www.cancerstaging.org/cstage/education/presentations.html This page includes the CS
presentations from the 2012 and 2011 NCRA meetings for anyone to download. The page also contains
the PowerPoint slides, the handouts, the quiz and the answer sheets for the seven CS webinars available
on the AJCC Education Portal. These materials have been made available so that all registrars may have
access to these important educational resources.
Recruitment and Retention of CTRs
NCRA has produced a series of PowerPoint presentations along with notes that can be used if you see a
need to present this topic locally.
http://www.ncra-usa.org/i4a/pages/index.cfm?pageid=3763
American Cancer Society Journals
CA: A Cancer Journal for Clinicians offers information on cancer prevention, early detection, treatment,
palliation, advocacy, quality of life, and other areas essential for clinicians and healthcare professionals
working on the front lines of oncology care. The journal’s content is available online without a
subscription.
Cancer publishes the latest peer-reviewed articles covering all oncologic disciplines for physicians and
researchers and the Annual Report to the Nation every other year. The journal’s content is offered for
free online 12 months after publication and abstracts can be viewed for free. Cancer publishes all
content online ahead of print.
Cancer Cytopathology publishes the latest peer-reviewed articles in cytopathology and related oncologic
disciplines for physicians and researchers. Content is offered for free online 12 months after publication
and abstracts can be viewed for free. Cancer Cytopathology publishes all content online ahead of print.
ACS Guidelines and Patient Pages gives you access to the most up-to-date cancer guidelines published in
CA. This publication can be obtained free online. To view the flipbook, go to cacancerjournal.com and
look on the left side bar under Special Features. For access to all of these journals, please visit online at
acsjournals.com.
Central Brain Tumor Registry of the United States
The Central Brain Tumor Registry of the U.S. (CBTRUS) announces the publication by Oxford University
Press of its latest report, CBTRUS Statistical Report: Primary Brain and Central Nervous System Tumors
Diagnosed in the United States in 2005-2009. The report is a supplement to the Society for NeuroOncology's official journal, Neuro-Oncology, and is available free to view on the CBTRUS website at
www.cbtrus.org by clicking on Reports and Tables. Data collected by the Centers for Disease Control and
Prevention’s National Program of Cancer Registries (NPCR) and the National Cancer Institute’s
Surveillance Epidemiology and End Results (SEER) program from 49 population-based cancer registries
were analyzed, revealing an incidence rate of 20.59 cases per 100,000 for all primary brain and central
nervous system tumors in 2005–2009. The efforts of hospital tumor registrars, central cancer registries,
and staff from NPCR and SEER to collect accurate and complete data have contributed to making this
report possible. A limited number of printed booklets may be requested by contacting
[email protected].
RESOURCES
The 10 Commandments of Windows Security
http://www.csoonline.com/article/704788/10-commandments-of-windows-security
Molecular Profiling for Unknown Primaries to Predict Tissue of Origin and Specific Therapy
http://jco.ascopubs.org/content/early/2012/10/01/JCO.2012.43.3755.abstract?sid=b529c2f9-daaa46f3-9cf1-bb04401ea289
Should Premenopausal breast cancer patients take tamoxifen for 10 years? Results of the ATLAS
study: http://www.aacr.org/home/public--media/aacr-in-the-news.aspx?d=2990
Is Axillary Node dissection important for survival when SLN are positive?
Results of ACOSOG Z0011:
http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=74&abstractID=
47842
Associated NCCN guideline: http://www.nccn.org/professionals/physician_gls/pdf/breast.pdf
A blog re-cap of triple negative breast cancer research:
http://curetoday.com/index.cfm/fuseaction/blog.showIndex/guest/2012/12/9/A-recap-oftriplenegative-breast-cancer-research-from-San-Antonio
A potential breakthrough in the treatment of triple negative breast cancer?
http://curetoday.com/index.cfm/fuseaction/blog.showIndex/debutripathy/2009/6/8/PARP-inhibitorscreate-buzz-at-ASCO
Wishing you much success and satisfaction in the new year,
Nancy H. Rold, CTR
QA Unit Supervisor
Missouri Cancer Registry and Research Center