Revisions to the FCDS Data Set NAACCR V10

1
Revisions to the FCDS Data Set NAACCR V10

• Mayra Alvarez, RHIT, CTR
• Megsys Casuso, CTR
• Mark Rudolph, MS
• Jill MacKinnon, CTR

2
Effects of V10

• Implications for all of us
• Conversion of data
• Some fields
• Layout
• Implementation of new software
• Learning new codes and rules (FORDS)

3
V10 Issues for FCDS

• June 30th last day to submit 2002 data in V9
  format
• July 1st July 14th FCDS IDEA offline
• No single entry
• No uploads
• KEEP ABSTRACTING during this period
• July 15th First day to upload V10 cases (after
  software verification)

4
V10 Issues for FCDS (cont)

• No downtime
• ROADS to FORDS (V9 V10)
• Affected V9 treatment codes will be converted to
  V10 (forward conversion)

5
Software

• FCDS single entry - Available July 15th
• Vendor software - Availability varies
• Facilities can continue to abstract using V9
  software (check with Vendor)
• Use Software - Tx codes will be converted from V9
  to V10
• Paper (ACoS worksheet) for COC required FORDS
  items

6
National Standards

• FCDS Follows The National Standards
• NAACCR
• CDC/NPCR
• NCI/SEER
• ACoS/COC

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Revisions At-A-Glance

• ? New fields
• ? Fields with changes in definitions
• ? Fields deleted

8
2003 Reporting Requirements

• New Standard Data Items
• New Definitions
• Changes to Exciting Data Items
• New NAACCR Edits Version 10
• New Florida Data Items
• New Documentation Requirements
• New Reference Manuals (FORDS)

9
2003 Reporting Requirements Ramifications

• Database Conversions
• Software Updates
• Internet Abstracting changes
• Internet Data Submission
• New Policies and Procedures
• New FCDS Data Acquisition Manual

10
Impact on Registrar

• Internet Access
• Training for New Surgery Data Items and new
  changes to existing Data Items
• Changes to Software

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Impact on FCDS

• Delays in Waiting for Information
• Convert Entire Database (2 million cases)
• New Policies Procedures
• Upgrading/Updating Edits
• Changing Internet Abstracting module
• Test V10 Internet Uploading Procedures

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Impact on FCDS

• New DAM
• Training for FCDS, Hospitals, Contractors
• Testing New System
• Testing New Vendor Software
• Testing New Edits
• Testing New Upload Procedures

13
Impact on Vendors

• Add New Data Items including State Items
• Change Programs
• Convert Databases
• New Edits
• Test Upload Procedures

14
NAACCR V10 Implementation

• Approved National Standard for all States
• Revisions to the Data Set
• Data Set Conversion
• Florida Implementation Date
• July 1, 2003

15
FCDS Conversion From NAACCR V9 to V10

• FCDS IDEA will not be accessible during the
  conversion period July 1 15, 2003
• This Effects
• Single Entry Module
• Batch upload
• FCDS web site will be up and available

16
New Data Fields V10

• Telephone Current
• Rx Date Transplant/Endocr
• Rx Summ Transplant/Endocr
• Rx Summ Surg Site 98-02
• Rx Summ Surg Oth/Dis 98-02
• Rx Summ Scope Reg LN Sug 98-02

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Telephone Current (New Data Item)

• Codes
• Valid telephone number (area code and number)
• Use 0000000000 if patient does not have a
  telephone
• Use 9999999999 if the telephone number
  unavailable or unknown

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Cases Diagnosed Before January 1, 2003
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Treatment Information

• For cases diagnosed before January 1, 2003
• the site specific surgery scheme consists of
• four data fields
• Rx Summ Surg Site 98-02
• Rx Summ Surg Oth/Dis 98-02
• Rx Summ Scope Reg LN Sug 98-02
• Rx Summ Regional Lymph Nodes Examined/Removed

20
Surgery FieldsDx before January 1, 2003

• All four fields are Site-Specific
• Rx Summ Surg Site 98-02
• Rx Summ Scope Reg 98-02
• Rx Summ Surg Oth 98-02
• Rx Summ Regional Lymph Nodes Examined/Removed

21
Cases Diagnosed On/AfterJanuary 1, 2003
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Treatment Information

• For cases diagnosed on or after January 1, 2003,
• The site specific surgery scheme consists of
  three
• data fields
• Rx Summ Surg of Primary Site
• Rx Summ - Scope of Regional LN Surgery
• Rx Summ - Surg Oth Reg/Dist

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Surgery Fields Dx on or after January 1, 2003

• Site-Specific field
• Rx Summ - Surg of Primary Site
• Non Site-Specific fields
• Rx Summ - Scope of Regional LN Surgery
• Rx Summ - Surg Oth Reg/Dist

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RX Summ - Surg Prim Site

• Effective for cases DX on or after January 1,
  2003
• Site-Specific using the FORDS surgical codes

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RX Summ - Surg Prim Site

• For Unknown and Ill-Defined Primary Sites and
  Hematopoietic/Reticuloendothelial/Immunoproliferat
  ing/Myeloproliferative disorder
• Code to 98 for any tumor characterized by the
  specific site and or histologies identified in
  the site specific
• Appendix H 2003
• Date Field 00000000

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Rx Summ - Scope Reg LN Sur (Item 1292)

• Effective for cases DX on or after January 1,
  2003
• All primary sites will have the same coding
  structure

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Rx Summ - Scope Reg LN Sur (Item 1292)
 
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Rx Summ Surg Oth Reg/Dis (Item 1294)

• Effective for cases DX on or after January 1,
  2003
• All primary sites will have the same coding
  structure
• This field records the surgical removal of
  regional tissues other than nodes, distant
  lymph nodes or other tissue(s)/organ(s) beyond
  this primary site

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RX Summ Surg Oth Reg/Dis (Item 1294)
 
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RX Summ Chemotherapy (Item 1390)

• Chemotherapy field expanded to two digits
• Treatments (non or actual) in 00-99 ranges
• Reasons treatment not administered in 82-88
  ranges
• Unknown is 99
• Date field

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RX Summ Chemotherapy (Item 1390)
00 None, chemotherapy was not part of the first
course of therapy not customary therapy for
this cancer 01 Chemotherapy, NOS 02 Chemotherapy,
single agent 03 Chemotherapy, multiple agents
(combination regimen) 82 Chemotherapy was not
recommended/administered because it was
contraindicated due to patient risk factors (co
morbid conditions, advanced age,
etc). 85 Chemotherapy was not administered
because the patient died prior to planned or
recommended therapy. 86 Chemotherapy was not
administered it was recommended by the patients
physician, but was not administered as part of
first-course therapy. No reason was noted in
the patient record 87 Chemotherapy was not
administered the patients physician recommended
it, but this treatment was refused by the
patient, the patients family member, or
patients guardian. The refusal was noted in
the patient record 88 Chemotherapy was
recommended, but it is unknown if it was
administered 99 Unknown if chemotherapy was
recommended or administered death certificate-
only cases
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RX Summ Hormone (Item 1400)

• Hormone field expanded to two digit
• Endocrine surgery and radiation moved to new
• Hematologic Transplant and Endocrine
  Procedures field
• Treatments (none or actual) in 00-99 ranges
• Reasons treatment not administered in 82-88
  ranges
• Unknown is 99

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RX Summ Hormone (Item 1400)

• 00 None, hormone therapy (including NOS and
  antihormones) was not part of the first course
  of therapy not customary therapy for this cancer
• 01 Hormone therapy
• 82 Hormone therapy was not recommended/administer
  ed because it was contraindicated due to patient
  risk factors (co morbid conditions, advanced
  age, etc.)
• 85 Hormone was not administered because the
  patient died prior to planned or recommended
  therapy.
• 86 Hormone was not administered it was
  recommended by the patients physician, but was
  not administered as part of first-course therapy.
  
• No reason was noted in the patient record
• 87 Patient, the patients family member, or the
  patients guardian refused hormone therapy as
  part of first-course therapy. The refusal was
  noted in the patient record
• 88 Hormonal therapy recommended, but it is
  unknown if it was administered
• 99 Unknown if hormonal therapy was recommended
  or administered death certificate-only cases

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RX Summ - BRM/Immuno (Item 1410)

• Immunotherapy field expanded to two digits
• Bone marrow transplant and stem cell procedure
  moved to NEW Hematologic transplant and Endocrine
  Procedures NAACCR item 3250 in 00-01 range
• The Reasons treatment not administered range
  82-88 codes
• Unknown is 99

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RX Summ - BRM/Immuno (Item 1410)

• 00 None, Immunotherapy was not part of the first
  course of therapy not customary therapy for
  this cancer
• 01 Immunotherapy
• 82 Immunotherapy was not recommended/administered
  because it was contraindicated due to patient
  risk factors (co morbid conditions, advanced
  age, etc.)
• 85 Immunotherapy was not administered because
  the patient died prior to planned or
  recommended therapy
• 86 Immunotherapy was not administered it was
  recommended by the patients physician, but was
  not administered as part of first-course therapy.
  No reason was noted in the patient record
• 87 Immunotherapy was not administered the
  patients physician recommended it, but the
  patient, the patients family member, or the
  patients guardian refused this treatment. The
  refusal was noted in the patient record.
• 88 Immunotherapy was recommended, but it is
  unknown if it was administered
• 99 It is unknown if Immunotherapy was
  recommended or administered death
  certificate-only cases

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Rx Summ -Transplnt/Endocr (Item 3250)(New Data
Item)

• Hematologic Transplant and Endocrine Procedures
  new data item
• Two digits field
• Endocrine Surgery and/or
• Endocrine Radiation (Breast/Prostate)
• The Reasons treatment not administered range
• 82-88 codes
• Unknown is 99

37
Rx Summ -Transplnt/Endocr (Item 3250)(New Data
Item)
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Rx Summ -Transplnt/Endocr (Item 3250) (New Data
Item)
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Rx Date Transplnt/Endocr (Item 2220)(New Data
Item)

• NEW FCDS Specific Field

40
RX Summ - Radiation (1360)

• COC will not support this field
• FCDS will continue to collect these codes

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Abstracted By

• Abstractor Initials will no longer be accepted
  on electronic abstract or abstract forms
• Cancer Abstractor Code Request form must be
  completed and returned to your Field Coordinator
• On and after July 1, 2003, no records will be
  accepted with an invalid abstractor code 
• Abstractors not on the approved abstractor list
  will be required to have 10 paper abstracts
  approved prior to receiving their code

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Primary Payer At Dx

• Changed from FCDS Primary Payer Current in
  State Specific Section to
• FORDS Primary Payer at Diagnosis NAACCR V10
  item number 630
• Record the type of insurance reported on the
  patients admission page

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Primary Payer At Dx

• 01 Not Insured
• 02 Not insured, self pay
• 10 Insurance, NOS
• 20 Managed Care, HMO, PPO
• 31 Medicaid
• 35 Medicaid administered through a Managed Care
  plan
• 36 Medicaid with Medicare supplement
• 50 Medicare
• 51 Medicare with supplement
• 52 Medicare with Medicaid supplement
• 53 TRICARE
• 54 Military
• 55 Veterans Affairs
• 56 Indian/Public Health Service
• 99 Insurance status unknown

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2003 FCDS DATA ACQUISITION MANUAL

• The data definitions in the DAM are derived from
  NAACCR v10, SEER, FORDS, NPCR and FCDS special
  fields

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Complete Revision of the FCDS DAM

• Distribution
• One copy per facility
• Available in August, 2003
• Additional copies may be ordered for a fee
• Ordering information on FCDS website
• Download from FCDS website
• Available July 1, 2003

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After Conversion July 15, 2003

• Vendor verification by facility
• 10 cases uploaded via FCDS IDEA on or after July
  15, 2003
• Also, submit a printed abstract form for each
  case from your system DO NOT ABSTRACT CASE ON
  FCDS PAPER ABSTRACT
• Field Coordinators will review the new V10
  submissions and approve facility for uploads

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Vendor verification

• Field Coordinator will review and approve each
  facilitys batch of 10 abstracts
• Field Coordinator will approve
• Facility free to begin uploading data
• OR
• Field Coordinator will disapprove
• Facility (vendor) must correct problem and
  resubmit 10 records

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Vendor verification
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Questions

• Please call and/or write FCDS with any questions.
  After responding to you, we will distribute the
  questions and answers on
• The FCDS website http//fcds.med.miami.edu
• FCDS Monthly Memo
• The Register Newsletter

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Thank You for all Your Hard Work and Dedication