Clinical Coding for CRS Standards

Transcription

1 Clinical Coding for CRS Standards The following appendices set out the amended PRIMARY DIAGNOSIS coding structure to be used for the monitoring of cancer waiting times following the implementation of 4th Revision of ICD-10 on 01 April 2012 (see AMD 86/2010). Appendix A: Exclusion of Basal Cell Carcinoma from the Dataset When entering data for patients with a diagnosis coded within ICD-10 C44.0 to C44.9 it is important that patients diagnosed with Basal Cell Carcinoma are excluded from the data-set as they are not covered by the cancer waiting times targets that are to be met by Therefore any definitions of the cancer types that are not to be entered onto the system will have to be defined by the morphology code of the particular neoplasm type as ICD-10 section C44 is classified by affected body area, for example, C44.1 of Eyelid. The table below specifies cancer types/sites to be excluded from the dataset: Specified Neoplasm ICD-10 Classification Morphology Code Basal Cell Carcinoma C44 M8090/3 Multicentric Basal Cell Carcinoma C44 M8091/3 Basal Cell Carcinoma, Morphoea C44 M8092/3 Basal Cell Carcinoma, Fibroepithelial C44 M8093/3 Basosquamos Carcinoma C44 M8094/3 Metatypical Carcinoma C44 M8095/3 Pilomatrix Carcinoma C44 M8110/3 If there is any problem removing a single neoplasm type from your dataset based upon the above information please consult the Basal Cell Neoplasm's section of ICD- O, which can be found under morphology codes M809-M811. No information for any patient diagnosed with a neoplasm that is contained within this section should be entered onto the system. Note: Basal Cell Carcinoma information is required for Cancer Registry purposes. Appendix B: Cancer Report Groupings for Primary Diagnosis (ICD-10) ICD-10 Description 31-Day reporting C00.0 External upper lip C00.1 External lower lip C00.2 External lip, C00.3 lip, inner aspect C00.4 lip, inner aspect C00.5 Lip,, inner aspect C00.6 Commissure of lip

2 C00.8 Overlapping lesion of lip C00.9 Lip, C01 Malignant neoplasm of base of tongue C02.0 Dorsal surface of tongue C02.1 Border of tongue C02.2 Ventral surface of tongue C02.3 Anterior two-thirds of tongue, part C02.4 Lingual tonsil C02.8 Overlapping lesion of tongue C02.9 Tongue, C03.0 gum C03.1 gum C03.9 Gum, C04.0 Anterior floor of mouth C04.1 Lateral floor of mouth C04.8 Overlapping lesion of floor of mouth C04.9 Floor of mouth, C05.0 Hard palate C05.1 Soft palate C05.2 Uvula C05.8 Overlapping lesion of palate C05.9 Palate, C06.0 Cheek mucosa C06.1 Vestibule of mouth C06.2 Retromolar area C06.8 Overlapping lesion of other and parts of mouth C06.9 Mouth, C07 C08 Malignant neoplasm of parotid gland Malignant neoplasm of other and major salivary glands C08.0 Submandibular gland

3 C08.1 Sublingual gland C08.8 Overlapping lesion of major salivary glands C08.9 Major salivary gland, C09 Malignant neoplasm of tonsil C09.0 Tonsillar fossa C09.1 Tonsillar pillar (anterior) (posterior) C09.8 Overlapping lesion of tonsil C09.9 Tonsil, C10.0 Vallecula C10.1 Anterior surface of epiglottis C10.2 Lateral wall of oropharynx C10.3 Posterior wall of oropharynx C10.4 Branchial cleft C10.8 Overlapping lesion of oropharynx C10.9 Oropharynx, C11.0 Superior wall of nasopharynx C11.1 Posterior wall of nasopharynx C11.2 Lateral wall of nasopharynx C11.3 Anterior wall of nasopharynx C11.8 Overlapping lesion of nasopharynx C11.9 Nasopharynx, C12 Malignant neoplasm of pyriform sinus C13.0 Postcricoid region C13.1 Aryepiglottic fold, hypopharyngeal aspect C13.2 Posterior wall of hypopharynx C13.8 Overlapping lesion of hypopharynx C13.9 Hypopharynx, C14.0 Pharynx, C14.2 Waldeyer's ring

4 C14.8 Overlapping lesion of lip, oral cavity and pharynx C15.0 Cervical part of oesophagus C15.1 Thoracic part of oesophagus C15.2 Abdominal part of oesophagus C15.3 third of oesophagus C15.4 Middle third of oesophagus C15.5 third of oesophagus C15.8 Overlapping lesion of oesophagus C15.9 Oesophagus, C16.0 Cardia C16.1 Fundus of stomach C16.2 Body of stomach C16.3 Pyloric antrum C16.4 Pylorus C16.5 Lesser curvature of stomach, C16.6 Greater curvature of stomach, C16.8 Overlapping lesion of stomach C16.9 Stomach, C17.0 Duodenum C17.1 Jejunum

5 C17.2 Ileum C17.3 Meckel's diverticulum C17.8 Overlapping lesion of small intestine C17.9 Small intestine, C18.0 Caecum C18.1 Appendix C18.2 Ascending colon C18.3 Hepatic flexure C18.4 Transverse colon C18.5 Splenic flexure C18.6 Descending colon C18.7 Sigmoid colon C18.8 Overlapping lesion of colon C18.9 Colon, C19 Malignant neoplasm of rectosigmoid junction C20 Malignant neoplasm of rectum C21.0 Anus, C21.1 Anal canal C21.2 Cloacogenic zone C21.8 Overlapping lesion of rectum, anus and anal canal

6 C22.0 Liver cell carcinoma C22.1 Intrahepatic bile duct carcinoma C22.2 Hepatoblastoma C22.3 Angiosarcoma of liver C22.4 sarcomas of liver C22.7 specified carcinomas of liver C22.9 Liver, C23 Malignant neoplasm of gallbladder C24.0 Extrahepatic bile duct C24.1 Ampulla of Vater C24.8 Overlapping lesion of biliary tract C24.9 Biliary tract, C25.0 Head of pancreas C25.1 Body of pancreas C25.2 Tail of pancreas C25.3 Pancreatic duct C25.4 Endocrine pancreas C25.7 parts of pancreas C25.8 Overlapping lesion of pancreas C25.9 Pancreas,

7 C26.0 Intestinal tract, part C26.1 Spleen C26.8 Overlapping lesion of digestive system C26.9 Ill-defined sites within the digestive system C30.0 Nasal cavity C30.1 Middle ear C31.0 Maxillary sinus C31.1 Ethmoidal sinus C31.2 Frontal sinus C31.3 Sphenoidal sinus C31.8 Overlapping lesion of accessory sinuses C31.9 Accessory sinus, C32.0 Glottis C32.1 Supraglottis C32.2 Subglottis C32.3 Laryngeal cartilage C32.8 Overlapping lesion of larynx C32.9 Larynx, C33 Malignant neoplasm of trachea C34.0 Main bronchus C34.1 lobe, bronchus or lung C34.2 Middle lobe, bronchus or lung C34.3 lobe, bronchus or lung C34.8 Overlapping lesion of bronchus and lung C34.9 Bronchus or lung, C37 Malignant neoplasm of thymus C38.0 Heart C38.1 Anterior mediastinum C38.2 Posterior mediastinum C38.3 Mediastinum, part

8 C38.4 Pleura C38.8 Overlapping lesion of heart, mediastinum and pleura C39.0 respiratory tract, part C39.8 Overlapping lesion of respiratory and intrathoracic organs C39.9 Ill-defined sites within the respiratory system C40.0 Scapula and long bones of upper limb C40.1 Short bones of upper limb C40.2 Long bones of lower limb C40.3 Short bones of lower limb C40.8 Overlapping lesion of bone and articular cartilage of limbs C40.9 Bone and articular cartilage of limb, C41.0 Bones of skull and face C41.1 Mandible C41.2 Vertebral column C41.3 Ribs, sternum and clavicle C41.4 Pelvic bones, sacrum and coccyx C41.8 Overlapping lesion of bone and articular cartilage C41.9 Bone and articular cartilage, C43.0 Malignant melanoma of lip C43.1 Malignant melanoma of eyelid, including canthus C43.2 Malignant melanoma of ear and external auricular canal C43.3 Malignant melanoma of other and parts of face C43.4 Malignant melanoma of scalp and neck C43.5 Malignant melanoma of trunk

9 C43.6 Malignant melanoma of upper limb, including shoulder C43.7 Malignant melanoma of lower limb, including hip C43.8 Overlapping malignant melanoma of skin C43.9 Malignant melanoma of skin, C44.0 of lip C44.1 of eyelid, including canthus C44.2 of ear and external auricular canal C44.3 of other and parts of face C44.4 of scalp and neck C44.5 of trunk C44.6 of upper limb, including shoulder C44.7 of lower limb, including hip C44.8 Overlapping lesion of skin C44.9 Malignant neoplasm of skin, C45.0 Mesothelioma of pleura C45.1 Mesothelioma of peritoneum C45.2 Mesothelioma of pericardium C45.7 Mesothelioma of other sites C45.9 Mesothelioma, C46.0 Kaposi's sarcoma of skin C46.1 Kaposi's sarcoma of soft tissue C46.2 Kaposi's sarcoma of palate C46.3 Kaposi's sarcoma of lymph nodes C46.7 Kaposi's sarcoma of other sites C46.8 Kaposi's sarcoma of multiple organs C46.9 Kaposi's sarcoma, C47.0 Peripheral nerves of head, face and neck

10 C47.1 Peripheral nerves of upper limb, including shoulder C47.2 Peripheral nerves of lower limb, including hip C47.3 Peripheral nerves of thorax C47.4 Peripheral nerves of abdomen C47.5 Peripheral nerves of pelvis C47.6 Peripheral nerves of trunk, C47.8 Overlapping lesion of peripheral nerves and autonomic nervous system C47.9 Peripheral nerves and autonomic nervous system, C48.0 Retroperitoneum C48.1 Specified parts of peritoneum C48.2 Peritoneum, C48.8 Overlapping lesion of retroperitoneum and peritoneum C49.0 Connective and soft tissue of head, face and neck C49.1 Connective and soft tissue of upper limb, including shoulder C49.2 Connective and soft tissue of lower limb, including hip C49.3 Connective and soft tissue of thorax C49.4 Connective and soft tissue of abdomen C49.5 Connective and soft tissue of pelvis C49.6 Connective and soft tissue of trunk, C49.8 Overlapping lesion of connective and soft tissue C49.9 Connective and soft tissue,

11 C50.0 Nipple and areola Breast Breast C50.1 Central portion of breast Breast Breast C50.2 -inner quadrant of breast Breast Breast C50.3 -inner quadrant of breast Breast Breast C50.4 -outer quadrant of breast Breast Breast C50.5 -outer quadrant of breast Breast Breast C50.6 Axillary tail of breast Breast Breast C50.8 Overlapping lesion of breast Breast Breast C50.9 Breast, Breast Breast C51.0 Labium majus Gynaecological Gynaecological C51.1 Labium minus Gynaecological Gynaecological C51.2 Clitoris Gynaecological Gynaecological C51.8 Overlapping lesion of vulva Gynaecological Gynaecological C51.9 Vulva, Gynaecological Gynaecological C52 Malignant neoplasm of vagina Gynaecological Gynaecological C53.0 Endocervix Gynaecological Gynaecological C53.1 Exocervix Gynaecological Gynaecological C53.8 Overlapping lesion of cervix uteri Gynaecological Gynaecological C53.9 Cervix uteri, Gynaecological Gynaecological C54.0 Isthmus uteri Gynaecological Gynaecological C54.1 Endometrium Gynaecological Gynaecological C54.2 Myometrium Gynaecological Gynaecological C54.3 Fundus uteri Gynaecological Gynaecological C54.8 Overlapping lesion of corpus uteri Gynaecological Gynaecological C54.9 Corpus uteri, Gynaecological Gynaecological C55 Malignant neoplasm of uterus, part Gynaecological Gynaecological C56 Malignant neoplasm of ovary Gynaecological Gynaecological C57.0 Fallopian tube Gynaecological Gynaecological C57.1 Broad ligament Gynaecological Gynaecological C57.2 Round ligament Gynaecological Gynaecological C57.3 Parametrium Gynaecological Gynaecological C57.4 Uterine adnexa, Gynaecological Gynaecological

12 C57.7 specified female genital organs C57.8 Overlapping lesion of female genital organs Gynaecological Gynaecological Gynaecological Gynaecological C57.9 Female genital organ, Gynaecological Gynaecological C58 Malignant neoplasm of placenta Gynaecological Gynaecological C60.0 Prepuce Urological Urological (Excluding C60.1 Glans penis Urological Urological (Excluding C60.2 Body of penis Urological Urological (Excluding C60.8 Overlapping lesion of penis Urological Urological (Excluding C60.9 Penis, Urological Urological (Excluding C61 Malignant neoplasm of prostate Urological Urological (Excluding C62.0 Undescended testis Urological Testicular C62.1 Descended testis Urological Testicular C62.9 Testis, Urological Testicular C63.0 Epididymis Urological Urological (Excluding C63.1 Spermatic cord Urological Urological (Excluding C63.2 Scrotum Urological Urological (Excluding C63.7 specified male genital organs C63.8 Overlapping lesion of male genital organs Urological Urological Urological (Excluding Urological (Excluding C63.9 Male genital organ, Urological Urological (Excluding C64 C65 Malignant neoplasm of kidney, except renal pelvis Malignant neoplasm of renal pelvis Urological Urological Urological (Excluding Urological (Excluding C66 Malignant neoplasm of ureter Urological Urological (Excluding

13 C67.0 Trigone of bladder Urological Urological (Excluding C67.1 Dome of bladder Urological Urological (Excluding C67.2 Lateral wall of bladder Urological Urological (Excluding C67.3 Anterior wall of bladder Urological Urological (Excluding C67.4 Posterior wall of bladder Urological Urological (Excluding C67.5 Bladder neck Urological Urological (Excluding C67.6 Ureteric orifice Urological Urological (Excluding C67.7 Urachus Urological Urological (Excluding C67.8 Overlapping lesion of bladder Urological Urological (Excluding C67.9 Bladder, Urological Urological (Excluding C68.0 Urethra Urological Urological (Excluding C68.1 Paraurethral glands Urological Urological (Excluding C68.8 Overlapping lesion of urinary organs Urological Urological (Excluding C68.9 Urinary organ, Urological Urological (Excluding C69 Malignant neoplasm of eye and adnexa C69.0 Conjunctiva C69.1 Cornea C69.2 Retina C69.3 Choroid C69.4 Ciliary body

14 C69.5 Lachrymal gland and duct C69.6 Orbit C69.8 Overlapping lesion of eye and adnexa C69.9 Eye, C70.0 Cerebral meninges C70.1 Spinal meninges C70.9 Meninges, C71.0 Cerebrum, except lobes and ventricles C71.1 Frontal lobe C71.2 Temporal lobe C71.3 Parietal lobe C71.4 Occipital lobe C71.5 Cerebral ventricle C71.6 Cerebellum C71.7 Brain stem C71.8 Overlapping lesion of brain C71.9 Brain, C72.0 Spinal cord C72.1 Cauda equina C72.2 Olfactory nerve

15 C72.3 Optic nerve C72.4 Acoustic nerve C72.5 and cranial nerves C72.8 Overlapping lesion of brain and other parts of central nervous system C72.9 Central nervous system, C73 Malignant neoplasm of thyroid gland C74.0 Cortex of adrenal gland C74.1 Medulla of adrenal gland C74.9 Adrenal gland, C75.0 Parathyroid gland C75.1 Pituitary gland C75.2 Craniopharyngeal duct C75.3 Pineal gland C75.4 Carotid body C75.5 Aortic body and other paraganglia C75.8 Pluriglandular involvement, C75.9 Endocrine gland, C76.0 Head, face and neck C76.1 Thorax C76.2 Abdomen C76.3 Pelvis C76.4 limb C76.5 limb C76.7 ill-defined sites C76.8 Overlapping lesion of other and ill-defined sites C77.0 Lymph nodes of head, face and neck C77.1 Intrathoracic lymph nodes

16 C77.2 Intra-abdominal lymph nodes C77.3 Axillary and upper limb lymph nodes C77.4 Inguinal and lower limb lymph nodes C77.5 Intrapelvic lymph nodes C77.8 Lymph nodes of multiple regions C77.9 Lymph node, C78.0 Secondary malignant neoplasm of lung C78.1 Secondary malignant neoplasm of mediastinum C78.2 Secondary malignant neoplasm of pleura C78.3 Secondary malignant neoplasm of other and respiratory organs C78.4 Secondary malignant neoplasm of small intestine C78.5 Secondary malignant neoplasm of large intestine and rectum C78.6 Secondary malignant neoplasm of retroperitoneum and peritoneum C78.7 Secondary malignant neoplasm of liver and intrahepetic bile duct C78.8 Secondary malignant neoplasm of other and digestive organs C79.0 Secondary malignant neoplasm of kidney and renal pelvis C79.1 Secondary malignant neoplasm of bladder and other and urinary organs C79.2 Secondary malignant neoplasm of skin C79.3 Secondary malignant neoplasm of brain and cerebral meninges C79.4 Secondary malignant neoplasm of other and parts of nervous system Urological Urological Urological (Excluding Urological (Excluding

17 C79.5 Secondary malignant neoplasm of bone and bone marrow C79.6 Secondary malignant neoplasm of ovary C79.7 Secondary malignant neoplasm of adrenal gland C79.8 Secondary malignant neoplasm of other specified sites C79.9 Secondary malignant neoplasm, site C80.0 Malignant neoplasm,primary site unknown, so stated Gynaecological Gynaecological C80.9 Malignant neoplasm, C81.0 Nodular lymphocyte predominant Hodgkin lymphoma C81.1 Nodular sclerosis classical Hodgkin lymphoma C81.2 Mixed cellularity classical Hodgkin lymphoma C81.3 Lymphocytic depleted classical Hodgkin lymphoma C81.4 Lymphocyte-rich classical Hodgkin lymphoma C81.7 classical Hodgkin disease lymphoma C81.9 Hodgkin's lymphoma, C82.0 Follicular lymphoma grade i C82.1 Follicular lymphoma grade ii

18 C82.2 Follicular lymphoma grade iii, C82.3 Follicular lymphoma grade iiia C82.4 Follicular lymphoma grade iiib C82.5 Diffuse follicle centre lymphoma C82.6 Cutaneous follicle centre lymphoma C82.7 types of follicular lymphoma C82.9 Follicular non-hodgkin's lymphoma, C83.0 B-cell lymphoma C83.1 Mantle cell lymphoma C83.3 Diffuse large B-cell lymphoma C83.5 Lymphoblastic (diffuse) lymphoma C83.7 Burkitt's lymphoma C83.8 types non-follicular lymphoma C83.9 Non-follicular (diffuse) lymphoma,

19 C84.0 Mycosis fungoides C84.1 Sézery's disease C84.4 Peripheral T-cell lymphoma, not elsewhere classified C84.5 mature T/NK-cell lymphomas C84.6 Anaplastic large cell lymphoma, ALK-positive C84.7 Anaplastic large cell lymphoma, ALK-negative C84.8 Cutaneous T-cell lymphoma, C84.9 Mature T/NK-cell lymphoma, C85.2 Mediastinal (thymic)large B-cell lymphoma C85.1 B-cell lymphoma, C85.7 specified types of non- Hodgkin's lymphoma C85.9 Non-Hodgkin's lymphoma, C86.0 Extranodal NK/T-cell lymphoma, nasal type C86.1 Hepatosplenic T-cell lymphoma

20 C86.2 Enteropathy-type (intestinal) T- cell lymphoma C86.3 Subcutaneous panniculitis-like T- cell lymphoma C86.4 Blastic N/K-cell lympthoma C86.5 Angioimmunoblastic T-cell lymphoma C86.6 Primary cutaneous CD30-positive T-cell proliferations C88.0 Waldenström macroglobulinaemia C88.2 heavy chain disease C88.3 Immunoproliferative small intestinal disease C88.4 Extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALTlymphoma) C88.7 malignant immunoproliferative diseases C88.9 Malignant immunoproliferative disease, C90.0 Multiple myeloma C90.1 Plasma cell leukaemia C90.2 Extramedullary plasmacytoma

21 C90.3 Solitary plasmacytoma C91.0 Acute lymphoblastic leukaemia [ALL] C91.1 Chronic lymphocytic leukaemia of B-cell type C91.3 Prolymphocytic leukaemia of B- cell type Acute leukaemia C91.4 Hairy-cell leukaemia C91.5 Adult T-cell lymphoma/leukaemia (HTLV-1-associated) C91.6 Prolymphocytic leukaemia of T- cell type C91.7 lymphoid leukaemia C91.8 Mature B-cell leukaemia Burkitttype Acute Leukaemia C91.9 Lymphoid leukaemia, C92.0 Acute myeloid leukaemia [AML] Acute leukaemia C92.1 Chronic myeloid leukaemia [CML],BCR/ABL-positive C92.2 Atypical chronic myeloid leukaemia, BCR/ABL-negative C92.3 Myeloid sarcoma C92.4 Acute promyelocytic leukaemia [PML] Acute leukaemia C92.5 Acute myelomonocytic leukaemia Acute leukaemia

22 C92.6 Acute myeloid leukaemia with 11q23-abnormality Acute leukaemia C92.7 myeloid leukaemia C92.8 Acute myeloid leukaemia with multilineage dysplasia Acute leukaemia C92.9 Myeloid leukaemia, Acute leukaemia C93.0 Acute monoblastic/monocytic leukaemia C93.1 Chronic myelomonocytic leukaemia C93.3 Juvenile myelomonocytic leukaemia Acute leukaemia C93.7 monocytic leukaemia Acute leukaemia C93.9 Monocytic leukaemia, C94.0 Acute erythroid leukaemia Acute leukaemia C94.2 Acute megakaryoblastic leukaemia Acute leukaemia C94.3 Mast cell leukaemia Acute leukaemia C94.4 Acute panmyelosis with myelofibrosis C94.6 Myelodysplastic and myeloproliferative disease not elsewhere classified C94.7 specified leukaemias Acute leukaemia C95.0 Acute leukaemia of cell type C95.1 Chronic leukaemia of cell type C95.7 leukaemia of cell type Acute leukaemia

23 C95.9 Leukaemia, C96.0 Multifocal and multisystemic (disseminated) Langerhans-cell histiocytosis [Letterer-Siwe disease] C96.2 Malignant mast cell tumour C96.4 of dendritic cells (accessory cells) C96.5 Multifocal and unisystemic (disseminated) Langerhans-cell histiocytosis C96.6 Unifocal Langerhans-cell histiocytosis C96.8 Histiocytic sarcoma C96.7 specified malignant neoplasms of lymphoid, haematopoietic and related tissue C96.9 Malignant neoplasms of lymphoid, haematopoietic and related tissue, C97 Malignant neoplasms of independent (primary) multiple sites D05.0 Lobular carcinoma in situ Breast Breast D05.1 Intraductal carcinoma in situ Breast Breast D05.7 carcinoma in situ of breast Breast Breast D05.9 Carcinoma in situ of breast, Breast Breast This coding classification will identify the tumour group of the cancer, the distinction between primary and secondary cancers for reporting purposes is controlled by the CANCER TREATMENT EVENT IDENTIFIER.