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

2. 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

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

4. NAACCR
ACoS/CoC
NCI SEER
NPCR
CCCR
NCRA
2017

5. 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

6. 2017 Reportability MCR Reporting Guidelines Changes
Registry ID vs. Reporting Facility ID
2017

7. Hospital System
Hospital A
Hospital B
Hospital C
Hospital D
2017

8. Outpatient Ambulatory Center
Hospital
RTC
Lab
Outpatient Ambulatory Center
Physicians
2017

9. 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

10. 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 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 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 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 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 for hospital C).
If reporting, it is the responsibility of the facility to designate its reporter.
Reporting Facility type
(Example: ID 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 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 ) for hospital B).
Enter different facility ID assigned by MCR based on the facility sending the data
(Example: ID for hospital A OR ID for hospital B).
Use facility ID assigned by MCR to reflect MCR
(Example: ID 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).

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

12. Edits
Version 16e
GenEDITS Plus v5
2017

13. 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

14. 2018

15. 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

16. 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

17. 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

18. DRAFT
DRAFT

19. 2018 NAACCR V18 Data Standards New/Changed data items
New record layout
2018

20. 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

21. 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

22. 2018 Changes to ICD-O-3 New terms for current codes New codes
Codes with changes in behavior
2018

23. 2018 New Treatment Data Items Expanded Radiation Therapy data items
Other changes to be determined
2018

24. 2018 Site Specific Data Items (SSDI) Replaces Site Specific Factors
Final list is in progress (biomarkers, genetic test, hormonal assays, etc.)
2018

25. 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

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

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

28. 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

31. What’s next?
2018

32. 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

33. 2018 Cancer Registry Software Development TNM.dll from CDC
Updates from NCI SEER
Hospital and central registry software updates
2018

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

35. 2018