Docstoc

Understanding and Coding Cancer Treatment

Document Sample
Understanding and Coding Cancer Treatment Powered By Docstoc
					Understanding and Coding Cancer Treatment
FCDS 2002 Educational Teleconference Series Jackie Button, MS
Steven Peace, CTR Mayra Alvarez, RHIT, CTR
October 16, 2002
1

Cornerstones for Treatment Decision-Making

2

First Course of Therapy
• For most cancers - Treatment usually begins
within four months from the date of initial diagnosis

• If treatments begins beyond four months from the
date of initial diagnosis please document it & send FCDS a copy of the documentation so we can ‘force’ it
3

First Course of Therapy
• Exception to 4-month rule - Leukemia
• Treatment begins within two months from the date
of initial diagnosis

• Why only two months for leukemia? • What about treatment consolidation or
maintenance?
4

First Course of Therapy
Planned
vs.

Actual

5

First Course of Therapy
Usual Treatment

Treatment Interruption
Change in Treatment Plan or Regimen

6

First Course of Therapy
Treatment Failure

Disease Progression
Co-Morbid Conditions

7

First Course of Therapy
• FCDS Edits • 240 Days - 4 Month Rule / 2 months Leukemia • 365 Days - Prostate & Breast Only • Why have these date edits? • Why can’t FCDS just fix or override these edits?
8

Subsequent Therapy
Therapy that starts after

the first course of treatment has failed or the cancer has recurred

9

NO Treatment
Watch and Wait Patient or Family Refused

Contraindicated Due to Other Medical Conditions (Co-Morbidity)
10

Curative Therapy
Treatment intent is to eliminate all traces of cancer in the patient

Goal is to cure the patient

11

Adjuvant Therapy
Treatment intent is to prevent or delay recurrence of original cancer. Treatment is given after other method(s) have destroyed all clinically detectable cancer.

Multi-modality Treatment
12

Palliative Therapy
Intent is to reduce the size and bulk of cancer and to alleviate symptoms caused by the cancer

Treatment is not intended to cure the patient of cancer

13

Ancillary Therapy
• Does not attack or destroy cancer cells
• Supports the body’s immune system or other body
systems without affecting the cancer directly

• Examples: Mesna, steroids, Procrit
14

FDA Approval Process
• Adult Clinical Trials • Phase I • Phase II • Phase III • Phase IV • Pediatric Clinical Trials • FDA Drug Info - http://www.fda.gov
15

Cancer.gov
NCI Cancer Information Web - http://cancer.gov SEER, PDQ & Cancer Information Service NCI - sponsored databases containing extensive and monthly updated information on cancer diagnosis, staging and treatment, including clinical trials. There is also a patient-oriented query available.

16

New Developments New Fields Changed Codes for 2003 Cases

17

Coding Co-morbidity & Complications
• Required for COC-approved cancer programs
beginning with January 1, 2003 cancer diagnoses

• FCDS will not require this information

• Refer to FORDS
• http://www.facs.org/dept/cancer
18

Date of First Course of Treatment
• Record the date on which treatment (surgery,
radiation, systemic, or other therapy) of the patient began at any facility

• Record the earliest of the following dates:
• • • •
Date of First Surgical Procedure Date Radiation Started Date Systemic Therapy Started Date Other Treatment Started
19

Date of First Course of Treatment
In cases of non-treatment, in which a physician decides not to treat a patient or a patient or patient’s family declines all treatment, the date of first course of treatment is the date this decision was made

20

Surgery
• Date of First Surgical Procedure
• Surgical Procedure of Primary Site - Site-Specific • Scope of Regional Lymph Node Surgery • Surgical Procedure/Other Site • Reason for No Surgery of Primary Site
21

Radiation Therapy
• COC requires collection and coding of several
detail-specific radiation therapy data items including;
• • • •
Location of Radiation Treatment Radiation Treatment Volume Regional Treatment Modality Regional Dose and other specific radiation dose info

• NPCR requires state registries to collect only
• - Rx Summ Radiation Therapy
22

Chemotherapy
• Change in Field Length to 2 characters

• SEER recommends 1-digit historical codes be stored
in the second character position preceded by a zero.

• COC recommends that historic codes be converted to
the current codes, using the algorithm it has developed

• SEER/FDA Update to SEER Book 8
23

Hormone Therapy
• Change in Field Length to 2 characters
• No more coding surgical procedures for
orchiectomy, oophorectomy or other surgicallyadministered hormonal manipulation

• Clarification - coding Prednisone & other steroids • SEER/FDA Update to SEER Book 8
24

BRM - Immunotherapy
• No change in field length
• • • •
Anti-angiogenesis agents (endostatin) Antisense agents Vaccine therapies Antibiotic therapy for lymphoma associated with Helicobactor Pylori

• SEER/FDA Update to SEER Book 8
25

Hematologic Transplant and Endocrine Procedures
• New Data Item • • • • •
Bone Marrow Transplant Stem Cell Harvest Radiation-directed endocrine therapy Endocrine Surgery Combination of any of the above
26

Treatment Dates
• Some software vendors will modify
programs so you do not have to code treatment-specific dates

• Some software vendors will not • Code 88888888 for recommended therapy
27

QUESTIONS ???

28

Links to Cancer Information
• • • • • • • • • • •
FCDS - http://www.fcds.med.miami.edu CDC/NPCR - http://www.cdc.gov/cancer/npcr NAACCR - http://www.naaccr.org CAP - http://www.cap.org SNOMED - http://www.snomed.org NCI Main Cancer Info - http://cancer.gov NCI/SEER - http://seer.cancer.gov ACoS/COC - http://www.facs.org/dept/cancer Florida DOH - http://www.doh.state.fl.us Florida C-CRAB - http://www.moffitt.usf.edu/ccrab Florida Legislature - http://www.leg.state.fl.us/Statutes

29

Thank You

30


				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:11
posted:11/15/2009
language:English
pages:30