Cancer Reporting Changes for 2017 and 2018 TRAM Presentation July 7, 2017 Mary Mesnard, RHIA, CTR

Information for this presentation is taken directly from the NAACCR 2017 and 2018 Implementation Guidelines for Cancer Registries. The goal today is to update TRAM with the most current information about what to expect for the coming years related to Guidelines changes Reporting changes ICD-O-3 and AJCC TNM Coding changes Other Changes 2017

“All great changes are preceded by chaos.” ~Deepak Chopra~ The one unchangeable certainty is that nothing is certain or unchangeable. ~John F. Kennedy~

NAACCR ACoS/CoC NCI SEER NPCR CCCR NCRA 2017

2017 ICD-O-3 Histologies New Terms and Codes Not Yet Implemented Reportability of NIFTP (Non-invasive follicular thyroid neoplasm with papillary-like nuclear features) as a New Term for EFVPTC (Encapsulated follicular variant of papillary thyroid carcinoma. NIFTP is synonymous with non-invasive EFVPTC Code to 8343/2 2017

2017 Reportability MCR Reporting Guidelines Changes Registry ID vs. Reporting Facility ID 2017

Hospital System Hospital A Hospital B Hospital C Hospital D 2017

Outpatient Ambulatory Center Hospital RTC Lab Outpatient Ambulatory Center Physicians 2017

Type of Health Care System Characteristic Type of Health Care System Single/Non-Networked Facility Networked/ Merged System Facility Affiliated with Hospital   Joint/Dual Partnership Federal Facility Facility Identified by Follow-Back Examples/ Description A community hospital with no ties to other health care system Private doctor’s office Freestanding facility with no affiliations, such as an independent pathology laboratory Multiple hospitals under one corporate system Freestanding radiation therapy center under one network system Physician practices with multiple locations Pathology laboratory under a larger university system Cancer program associated with a large hospital or university University treatment center that is operated under a hospital corporation Regional treatment center with two hospitals as equal partners VA hospital Walter Reed National Military Medical Center Military base hospital Nursing home or hospice that does not usually report Ownership/ Administrative Control One facility owns/controls One system owns/controls multiple facilities; facilities fall under the “umbrella” of the system One facility owns/controls one or more facilities More than one facility owns/controls Federal government Staffing Staff are from one facility Staff come under one system Staff are from two facilities Staff are federal government employees/ contractors EMR System One EMR system Same EMR system at separate locations May have separate EMR systems at one location May or may not have a single EMR system

Type of Health Care System Characteristic Type of Health Care System Single/Non-Networked Facility Networked/ Merged System Facility Affiliated with Hospital Joint/Dual Partnerships Federal Facility Facility Identified by Follow-Back Reporting Facility (major data source) Enter facility ID assigned by MCR (Example: ID 0000012345 for hospital A).   It is the responsibility of the facility to designate its reporter. Use facility ID assigned by MCR to the specific hospital. Do not use the corporate level (network) facility ID if available (Example: ID 0000034567 for hospital B vs. using the network ID). Enter facility ID assigned by MCR for the facility where the data is coming from (Example: ID 9999901234 for RTC A assoc. w/ hospital B). Enter facility ID assigned by MCR for the facility where the data is coming from when separate reporting by facility (Example: ID 9999902345 for RTC B assoc. w/ hospitals A and B) unless a formal agreement exists for one cancer registry to pick up all cases. It is the responsibility of the facility to designate its reporter. If a formal agreement exists, the cancer registrar should report ALL cases seen for care at the separate facilities. Use facility ID assigned by MCR Note: Federal facilities report with a signed agreement (Example: ID 0000056789 for hospital C). If reporting, it is the responsibility of the facility to designate its reporter. Reporting Facility type (Example: ID 888880123 for nursing home A). Registry ID (sender) Enter same facility ID as Reporting Facility Enter same facility ID as Reporting Facility when the reporter is the same as the data source (Example: ID 0000012345 for hospital A) ; otherwise, the Registry ID and Reporting Facility will be different (Hospital A reports for Hospital B). Enter different facility ID as Reporting Facility (Example: ID 0000034567) for hospital B). Enter different facility ID assigned by MCR based on the facility sending the data (Example: ID 0000012345 for hospital A OR ID 0000034567 for hospital B). Use facility ID assigned by MCR to reflect MCR (Example: ID 0000002100 for MCR). Type of Reporting Source Code according to Reporting Facility (Example: hospital A = 1). (Example: RTC A = 2). (Example: RTC B = 2). (Example: hospital C = 1). (Example: nursing home A = 5).

Multiple Primary and Histology (MP/H) Rules No change 2017

Edits Version 16e GenEDITS Plus v5 2017

2017 Standard Setters Reporting Requirements CoC – minor updates in FORDS Allowable values for Sex Mets at DX-Other – added code 2 – Generalized metastases such as carcinomatosis Clarifications for Tumor Size Summary Pagination corrected for the First Course of Treatment Section Site Specific Surgery Codes for SKIN updated to state “1 cm or more” CDC-NPCR – no changes 2017

2018

2018 AJCC 8th Edition TNM Coding Extent of Disease Coding (EOD) NAACCR V18 Data Standards Summary Stage 2018 Revised MP/H to Solid Tumor Manual Changes to ICD-O-3 New Treatment Data Items Site Specific Data Items STORE Manual EDITS/TNM Edits 2018

2018 AJCC 8th Edition Staging Required for all CoC facilities Required as available from Non-CoC facilities Verification of all histologies in each AJCC chapter with WHO vs. ICD-O-3 Completion will effect the TNM.dll and edits 2018

2018 Extent of Disease Coding (EOD) NPCR will partner with NCI to collect EOD from NPCR-funded registries that choose to participate in collection of EOD data items. Training will be available 2018

DRAFT DRAFT

2018 NAACCR V18 Data Standards New/Changed data items New record layout 2018

Summary Stage 2018 Designed to reflect changes in the 8th edition AJCC Staging Manual Directly assigned SS2018 will be available for registries that do not collect EOD data items. Registries that collect EOD will have a derived stage available. 2018

2018 Revised MP/H to Solid Tumor Manual New rules for determining multiple primaries and histologies New name “Solid Tumor Manual” Draft has been completed, under review 2018

2018 Changes to ICD-O-3 New terms for current codes New codes Codes with changes in behavior 2018

2018 New Treatment Data Items Expanded Radiation Therapy data items Other changes to be determined 2018

2018 Site Specific Data Items (SSDI) Replaces Site Specific Factors Final list is in progress (biomarkers, genetic test, hormonal assays, etc.) 2018

2018 STORE Manual (formerly known as FORDS) Designed to reflect changes in the AJCC 8th Edition Staging Manual Updated to reflect new non-staging related data New manual format 2018

EDITS/TNM Edits Updates and changes will be required based on new histologies and new data items 2018

ICD-11-MMS ICD-O-4? ICD-11-CM? 2018

2018 AJCC 8th Edition EOD Coding Summary Stage 2018 Revised MP/H to Solid Tumor Manual ICD-O-3 changes New Treatment data items SSDI STORE Manual ICD-11-MMS NAACCR Standards Volume II, Version 18 EDITS/TNM EDITS 2018

What’s next? 2018

Finalize NAACCR Standards Volume II and submit to NAACCR Board for review/approval June 1, 2017 UDS final approval at May 2017 UDS meeting. NAACCR Standards Volume II Released July 1, 2017   NAACCR 2018 Implementation Guidelines Released August 1, 2017 EDITS metafile release September 1, 2017 EDITS Work Group will have begun development of edits metafile by February 2017. Education and training Ongoing as material becomes available For 2018 implementation: develop and implement educational materials by summer 2017. Implementation January 1, 2018 2018

2018 Cancer Registry Software Development TNM.dll from CDC Updates from NCI SEER Hospital and central registry software updates 2018

Where do you find help? Let the central registry be your primary point of contact for questions regarding Changes Coding Edits 2018

2018