LDH Post-Orchiectomy Range (Testis)

Note 1 Physician Statement

• Physician statement of the LDH (Lactate Dehydrogenase) Post-Orchiectomy Range can be used to code this data item when there is no other information available.

Note 2 Timing

• Record the range of the LDH test as documented in the medical record after orchiectomy but prior to adjuvant therapy. The lab value may be documented in a lab report, history and physical, or clinical statement in the pathology report.

Note 3 Calculating the upper limit

• To calculate whether the lab result is in a particular range, multiply the lab’s upper limit of normal (usually stated on the report) times the stated multiplier. If the test is elevated, determine whether it is less than 1.5 times the upper limit of normal (code 1), between 1.5 and 10 times the upper limit of normal (code 2), or more than 10 times the upper limit of normal (code 3) (See coding guidelines for example).

Note 4 Lab values elevated after orchiectomy

• If the initial post-orchiectomy LDH remains elevated, review subsequent tests, and record the lowest LDH value (normalization or plateau) prior to adjuvant therapy or before the value rises again.

Note 5 LDH and Testis

• Of the three tumor markers, lactate dehydrogenase (LDH) is the least specific for testicular cancer. The magnitude of LDH elevation directly correlates with Testis tumor burden.

Note 6 Related data item

• If the pre-orchiectomy LDH was normal, a post-orchiectomy LDH may not be performed. In this case, code 5 should be recorded.