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Coding Grade: 2014 changes

Jessica K. Dohler, BS, CTR. Coding Grade: 2014 changes. Background & Overview. Need for Change. Complicated Site Specific Grading No easy conversion to available codes Need for special guidelines FORDS vs. SEER CoC stopped supporting conversion of special codes in 2012

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Coding Grade: 2014 changes

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  1. Jessica K. Dohler, BS, CTR Coding Grade:2014 changes

  2. Background & Overview

  3. Need for Change • Complicated Site Specific Grading • No easy conversion to available codes • Need for special guidelines • FORDS vs. SEER • CoCstopped supporting conversion of special codes in 2012 • SEER continued support of conversion • Confusion was rampant

  4. Combination of Efforts • SEER, CoC & NPCR • Rules standardized across the board • EVERYONE follows the same rules now

  5. General Rules to Remember • Always pick up highest grade • Foci • Bx • Code grade from primary site only • Only code grade prior to systemic or radiation treatment • When both in situ and invasive are present code from invasive only

  6. Summary of Grade Coding Instructions • 2014 cases • Changes mainly affect coding grade for solid tumors • To code grade for Hematopoietic and Lymphoid Neoplasms continue to reference Hematopoietic Database

  7. Solid Tumor Grading System Priority • Site Specific or Special Grading • Nottingham-Bloom-Richardson, Gleason, Fuhrman • General Grading Systems • Two, three or four tier system • Special rules for breast & prostate • Terminology only • Terms that are not used in general grading systems

  8. #1 Special Grading Systems

  9. Special Grading Systems • Code grade using same info used to code grade site specific factors • Breast – SSF7 • Prostate – SSF8 & SSF10 • Soft Tissue/Sarcoma – SSF1 • Kidney – SSF6 • Code the special grade even if a general grade system or term is higher

  10. Special Grade – BreastNottingham-Bloom-Richardson • Score takes precedence

  11. Special Grade – ProstateGleason • Code the grade based on whichever SSF is higher

  12. Special Grading – Soft Tissue/Sarcoma • Numeric grade takes precedence • Be cognizant of unusual grade conversion

  13. Special Grade – KidneyFuhrman • Straight forward coding

  14. #2 General Grading Systems

  15. General Grading Systems • If there is no special grade look for general grading system • Special codes for breast & prostate Two Tier General Grading System

  16. General Grading Systems Three Tier General Grading System Four Tier General Grading System

  17. #3 Terminology Only

  18. Terminology Only • If there is no special grade or general grading system look for terminology • Entire listing of terms can be found in FORDS and on SEER website • Outliers for breast & prostate

  19. Review

  20. Review • Remember general grade coding guidelines • Order of Priority • Special Grade • General Grade System • Terminology • Code unknown if no description fits

  21. NCRA Education Committee 2014. Vida, C and Mitchell, S. Free download. http://www.cancerregistryeducation.org/Files/Org/f3f3d382a7a242549a9999654105a63b/site/2014_Grade_Flow_Chart.pdf

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