[Recinda Sherman]

This year the county-tract combo edit is no longer optional.

If you experience a large number of edit failures from the county-tract combo edit, there are likely 2 problems:

1) your geocoded tract was not placed in the proper place or is wrong (many registries have found junk in the field–letters, etc).To resolve this, the geocoded data will need to be uploaded in your database again.
2) your reported county differs from the geocoded county. The registry will need to overwrite (at least for the purposes of call for data) the reported county (Item 90) with the geocoded county data. The decade of diagnosis should match the geocoded county decade (1995-1999 dx cases should use the Geocoded County 1990; 2000-2009 dx cases should use the Geocoded County 2000; 2010-2015 dx cases should use the Geocoded County 2010).
NOTE: The edit will only catch cases where a tract does not match a county. So you will need to overwrite County at DX (Item 90) with the geocoded county for ALL cases that are geocoded; not just the cases that do not pass edits. This is because tract 001100 can be in multiple counties. It might pass the edit but if the reported county does not match geocoded county, it would result in the incorrect calculation of poverty code, etc.
NOTE: For cases that are not geocoded, do not overwrite County at DX with blanks. We do not want to lose information.

[Recinda Sherman]

When Jim and I were investigating some cases that generated errors this year, there were a few plain incorrect codes. However, we found a number of correct ICD codes but they were procedure codes, not diagnosis codes. I suspect that the edit was updated so that procedure codes, regardless of whether they are valid ICD codes, are not allowed in the cause of death fields. Only diagnosis codes should be used in the cause of death field.

[Recinda Sherman]

Howdy!

There are 2 reasons for being so fussy about using geocoded county codes:

1–to ensure correct calculation of county-level rates–a standard statistic reported by most central registries.
Geocoding is very useful in ensuring the correct county. It is more precise–unlike the USPS system, a geocoded county reflects the actual county of an address when a city or zip crosses county lines. And geocoding can correct miscodes stemming from a mistype or a common error like keying in the facility county instead of the patient’s county. Please note, that for small counties, using the geocoded county instead of the reported county will result in changes in rates. In general, small counties without cancer facilities will gain cases and can see higher rates using the geocoded county. Large, metro counties with large hospitals will lose cases but generally not enough to impact the rates.
NOTE: it is important to use the geocoded county for county rates only when the case has been geocoded. A registry does not want to overwrite a county reported by the facility with a blank for geocoded county–else we lose information.
2–to ensure correct tract is used for tract-level poverty code and urban/rural codes.
The tract number is only unique when combined with state and county. Tract number 001100 is a common tract number that is valid for most counties in the US. So if the reported county is wrong, the poverty codes and other SES area-based measures are also wrong. The use of these SES area-based measures have become a critical component to our understanding of the health of communities.

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