Jim Hofferkamp

Jim Hofferkamp

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Viewing 15 posts - 31 through 45 (of 56 total)
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  • in reply to: C328 or C329 #5095
    Jim Hofferkamp
    Keymaster

    Hi Barbara,
    This is a known issue and there has been a great deal of discussion on how to handle these cases. The next version of edits has been loosened so that it allows the value of 88 along with all of the valid values for the larynx chapter for c32.8 and c32.9 primaries. That should fix the edits issues, but it doesn’t really solve the coding issue.

    You have identified the problem. If the primary site is C32.8 or C32.9, the computer does not know which T values to use. No only is this a problem with the edits, but it is also a problem with the program central registries use to calculate stage.

    The Edits WG wrote an article that will be in the next issue of Journal of Registry Management addressing this issue. At this point we are strongly encouraging registrars to assign the primary based on the epicenter of the tumor. So if the epicenter of the tumor is located in the supraglottis but the tumor also involves the glottis, then the primary site should be coded to supraglottis.

    in reply to: Choroid Melanoma Edit #5091
    Jim Hofferkamp
    Keymaster

    It does. This is a known issue and has been corrected in the v16d metafile.

    We are hoping to have the v16d metafile out late next week.

    in reply to: Site C600/edits #5090
    Jim Hofferkamp
    Keymaster

    Good catch Julie!
    We updated this edit so it passes if the clin N is blank. We found another edit with the same issue. See the summary of changes below.

    Added skipfor TNM Clin N only = blank. TNM Path N = blank skipped for checks on SSF 3 codes 005 and 010.
    2 edits modified, TNM N, SSF 3 Melanoma os Skin (CoC); TNM N, SSF 3 Merkel Cell (CoC)

    in reply to: Blank pM when you have a valid pT & pN (not blank) #5089
    Jim Hofferkamp
    Keymaster

    FYI…we’ve developed some edits for this situation, but central registries will have to be careful about adding them to their edit sets. While AJCC says if the T value is not blank, then the N and M should not be blank, that really applies to registrars that have a chart to work from. NPCR want to allow path labs and other non-hospital facilities the ability to just enter the information they have. So if they just have a T value, they want them to enter the T value and leave the other fields blank.

    We may only add these new edits to the CoC edit set. We’ll include the new edits in the metafile, but not in the any of the SEER or Central registry edit sets.

    I think we are going to have an instructional webinar after the release of v16d to explain (among other things) the pros and cons of adding these edits to a central registry edit set.

    in reply to: Anaplastic Thyroid Path Stage #5087
    Jim Hofferkamp
    Keymaster

    Hi Barbara,
    Your staging is correct! We should have allowed a stage group 99 for anaplastic thyroid carcinoma. The edit tables have been updated and the corrected edit will be included in the v16d metafile. Hopefully, the v16d metafile will be released in early February. Until that time, please have your registrar hold the case until the v16d metafile is available to them and they can submit the correct data.

    in reply to: TNM Path T, N, M, In Situ (COC) #4617
    Jim Hofferkamp
    Keymaster

    This edit is incorrectly expecting the clinical T value to reflect the pathologic T value. This has been corrected and will be included in v16d. This edit has gone through quite a few changes since it was released in v16. Below is a summary of changes.

    NAACCR v16A

    – Corrected logic for first INLIST of primary sites for site/histology group 57A, 000-419-440 changed to 000-440.
    – Description and logic updated to skip edit for Carcinoma of Conjunctiva, Melanoma of Conjunctiva.
    – Corrected Edit Logic to include 9727 as lymphoma rather than lymphoma/leukemia code, to delete 9728-9729 as obsolete codes
    – Added Group 57C, C420, C421, C424, 9811-9818, 9837,to Edit Logic

    NAACCR v16B
    – Name changed from TNM T,N,M, In Situ (CoC) to TNM Path T,N,M, In Situ (COC)
    – Description and Edit Logic updated to allow TNM Clin T to be blank and TNM Clin Stage Group to equal 99 when TNM Path T is in situ. This logic assumes that In situ carcinoma was not diagnosed clinically and is an incidental finding at surgery.
    – Logic statements requiring that TNM Clin N, TNM Clin M, and TNM Clin Stage Group are also coded consistently with TNM Path T = in situ removed from edit; consistency of coding for TNM Clin fields checked in another edit, TNM Clin T,N,M, In Situ (COC).
    – Description and logic updated to edit Carcinoma of Conjunctiva and Melanoma of Conjunctiva for TNM Path N and TNM Path M and only skip for TNM Path Stage Group
    – Error messages updated to be more specific about coding problems
    – Corrected edit logic for assigning site/histology group 011 to group 10B or 999 based on histology and CS Site-Specific Factor 25

    NAACCR v16D
    – Description, logic modified to skip if TNM Edition Number not = 07,U7
    – Description, edit logic modified to omit comparison between clin TNM and stage group and path TNM and stage group values.
    – Modified logic, format of character string, e.g. “pxxb”, 2,3
    – Logic corrected to skip for group 009, Mucosal Melanoma of Head and Neck
    – Description, logic modified to not include pNX as allowable code for in situ carcinomas

    in reply to: Blank pM when you have a valid pT & pN (not blank) #979
    Jim Hofferkamp
    Keymaster

    A central registry sent me the comment below.

    You mentioned on the forum (https://www.naaccr.org/forums/topic/blank-pm-when-you-have-a-valid-pt-pn-not-blank/) that you will decide based on feedback from registries to see whether an edit will be added to address the issue where reporters submit 2016 diagnosis year cases with valid pT and pN and Stg Grp but leaving pM blank.

    We did a search in our central registry database and as of today 1/5/2017, we have 2968 abstracts from reporters where pathologic T and N are completed but pathologic M is left blank. When these cases are in pending and staff consolidates the cases, we get a pop-up screen in our software (prior to edits) that prompts for the pathologic M field. But many cases go straight through into the database without being in pending so those will have to require a separate manual review. As Michael Castera mentioned in the same forum thread (link above), it would be a useful edit to include in our edit set so the missing field can be caught prior to it going into the database.

    in reply to: Edit or reportability question #4513
    Jim Hofferkamp
    Keymaster

    The “intraepithelial carcinoma” is reportable and the registrar coded it correctly (8010/2). There is a SEER SINQ post that confirms this.

    If you look in your AJCC manual in the ovary chapter (pg 419), you’ll see that there isn’t a stage group 0 (in situ). Since there is not a stage group for this site/histology combination, it is appropriate to enter 88 in the T, N, M and stage group data items.

    I really don’t think this has received enough attention in the educational materials (at least not in the NAACCR webinars). I will make sure this coding instruction does get included in upcoming webinars.

    in reply to: Primary Site, TNM Clin Stage Valid B-Ed 7 (COC) #4512
    Jim Hofferkamp
    Keymaster

    In the scenario above, the edit is working correctly. This is sezary’s disease primary (see chapter 57B Primary cutaneous lymphoma pg 613 in AJCC manual).

    cT4 cNX cM0 should not equal stage group 4A1. When we discussed this off-line you mentioned that the registrar had also tried to enter clinical stage group of 99 and the edit failed.

    The edit should have allowed stage group 99 in that scenario. We will update the edit to allow cT4 cNX cM0 stage group 99.

    The update will be included in the v16d metafile scheduled for release in late January/early February.

    in reply to: Carinoma error for a Melanoma Primary #4511
    Jim Hofferkamp
    Keymaster

    Thanks Denise,
    This edit is intended to apply only to carcinoma of the skin (AJCC Chapter 29)that is invading into the mandible, maxilla, orbit, or temporal bone (T3). If the T value is T3, then the primary site has to be a skin site that is in the region of one of these sites. There is an error in the logic so the edit also includes melanomas (chapter 31).

    The edit has been corrected and will be included in the v16d release in late January or early February.

    Thank you for you post!

    in reply to: Blank pM when you have a valid pT & pN (not blank) #4509
    Jim Hofferkamp
    Keymaster

    That’s a good question Nancy.The TNM Edits WG is trying to minimize changes to v16 edits that tighten the coding rules. Our focus right now is on edits that are not allowing registrars to enter correct information.

    Another consideration for this edit is it could potentially create a lot of work at the central and hospital registry level. I would hate to see registries that are already strapped for time have to go back and make all these changes manually.

    However, if central registries feel strongly that this edit should be included, i think we could make an exception. The edit logic is fairly simple. We will have to make a decision in the next couple of weeks.

    in reply to: Blank pM when you have a valid pT & pN (not blank) #4507
    Jim Hofferkamp
    Keymaster

    I think a lot of registrars are having a hard time adjusting to the fact they need to include a cM value in the pM data item in certain situations.

    We do not have an edit in the current metafile to address this situation.

    The edit would be relatively simple. If the pT was not empty, then the pM must not be empty.

    The edits WG is making an effort not to introduce any new edits or make adjustments to current edits that tighten the allowable codes. We are trying to save these types of changes for v18.

    However, if this is something central registries would really like to add to their metafiles, we could make an exception.

    We are going to release the next metafile (v16d) in late January or early February. If I hear back from enough registries before that, we could add an edit to address this situation.

    I encourage metafile administrators to respond to this thread if they see the empty pM as an issue at their registry.

    in reply to: GIST Tumors and TNM Path N, Reg Nodes Ex – Ed 7 (CoC) #4506
    Jim Hofferkamp
    Keymaster

    For this case the appropriate thing to do is leave the data item pN blank. The stage can still be calculated based on an implied cN0.

    in reply to: GIST Tumors and TNM Path N, Reg Nodes Ex – Ed 7 (CoC) #4504
    Jim Hofferkamp
    Keymaster

    Somebody please correct me if i’m wrong, but i think the edit is correct. The issue is how to enter information in the pN data item, when clinical information is used to calculate the stage group.

    From what i understand, it would be appropriate to calculate the pathologic stage for this site/histology even if no lymph nodes were removed. However, we would be using a cN0 to calculate the stage group. A pN0 would only be used if lymph nodes were removed.

    The below is the logic description for the edit TNM Path N, Reg Nodes Ex – Ed 7 (CoC). The edit would pass if the pN data item is a cN0 or blank.

    This edit is skipped if any of the following conditions are true:

    1. Year of Date of Diagnosis is less than 2016, blank (unknown), or invalid
    2. Type of Reporting Source = 6 (Autopsy Only) or 7 (Death Certificate Only)
    3. Behavior Code ICD-O-3 = 0 (benign) or 1 (borderline)
    3. TNM Path N is blank or 88
    4. Regional Nodes Examined = blank

    IF Regional Nodes Examined = 00 or 99
    Then
    TNM Path N must = pX, c0, or blank

    in reply to: State Edits vs COC Required Edits #4502
    Jim Hofferkamp
    Keymaster

    You can send them to me.

    You can either send them through this blog site or send them to me through email. I’ll work with the TNM Edits WG to clarify them. Sometimes it is difficult to tell if the issue is related to the edits or if it is a coding issue. When in doubt, send them to me.

    Once the NAACCR call for data is over (thursday) I’m going to start posting known edit issues to this site. We have had several issues pop up since we released the v16d metafile. I just haven’t had time to get them posted.

    As an fyi…we are hoping we won’t release another metafile update until late January or early February. If you have a registry that has a case they are coding correctly but can’t get past the edits, have them hold the case until the next update.

    So far, all of the issues we have identified since the release of v16c are not things that will impact a lot of cases.

Viewing 15 posts - 31 through 45 (of 56 total)

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