RX Summ--Transplnt/Endocr [3250]
- David Rust
- michelle.gray
- tonya.brandenburg (Unlicensed)
Organization | Field Name | ID | Required |
|---|---|---|---|
KCR | RX Summ--Transplnt/Endocr [3250] (NATransplntEndocr) | 60430 | No |
NAACCR | RX Summ--Transplnt/Endocr | No |
Field Length: 2
This is a calculated field which identifies transplant and endocrine surgeries/radiation administered at any facility as part of the first course of treatment.
This data item records systemic therapeutic procedures administered as part of the first course of treatment. These procedures include bone marrow transplants (BMT) and stem cell harvests with rescue (stem cell transplant), endocrine surgery and/or radiation performed for hormonal effect (when cancer originates at another site), and a combination of transplants and endocrine therapy.
Code | Description |
|---|---|
00 | None, transplant procedure or endocrine therapy was not a part of the first course of therapy; not customary therapy for this cancer; diagnosed at autopsy only |
10 | Bone marrow transplant, NOS. A bone marrow transplant procedure was administered as first course of therapy, but the type was not specified. |
11 | Bone marrow transplant autologous |
12 | Bone marrow transplant allogeneic |
20 | Stem cell harvest and infusion (stem cell transplant) |
30 | Endocrine surgery and/or endocrine radiation therapy as first course therapy |
40 | Combination of transplant procedure with endocrine surgery and/or endocrine radiation (Code 30 in combination with 10, 11, 12, or 20) as first course of therapy |
82 | Transplant procedure and/or endocrine therapy was not recommended/administered because it was contradicted due to patient risk factors (comorbid conditions, advanced age, etc.) |
85 | Transplant procedure and/or endocrine therapy was not administered because the patient died prior to planned or recommended therapy |
86 | Transplant procedure and/or endocrine therapy was not administered; it was recommended by the patient’s physician but was not administered as part of first course therapy. No reason was noted in the planned or recommended therapy. |
87 | Transplant procedure and/or endocrine therapy were not administered; this treatment was recommended by the patient’s physician but was refused by the patient, a patient’s family member, or the patient’s guardian. The refusal was noted in the patient record. |
88 | Transplant procedure and/or endocrine therapy was recommended, but it is unknown if it was administered |
99 | It is unknown if a transplant procedure or endocrine therapy was recommended or administered because it is not stated in patient record |
Definitions
Bone marrow transplant (BMT): Procedure where bone marrow is used to restore stem cells that were destroyed by chemotherapy and/or radiation. Replacing the stem cells allows the patient to undergo higher doses of chemotherapy.
BMT Allogeneic: Receives bone marrow from a donor. This includes haploidentical (or half-matched) transplants.
BMT Autologous: Uses the patient’s own bone marrow. The tumor cells are filtered out and the purified blood and stem cells are returned to the patient.
BMT Syngeneic: Bone marrow received from an identical twin.
Conditioning: High-dose chemotherapy with or without radiation administered prior to transplant such as BMT and stem cells to kill cancer cells. This conditioning also destroys normal bone marrow cells so the normal cells need to be replaced (rescue). The high dose chemotherapy is coded in the Chemotherapy data item and the radiation is coded in the Radiation Treatment Modality--Phase I, II, III data items.
Hematopoietic growth factors: A group of substances that support hematopoietic (blood cell) colony formation. The group includes erythropoietin, interleukin-3, and colony-stimulating factors (CSFs). The growth-stimulating substances are ancillary drugs and not coded.
Non-myeloablative therapy: Uses immunosuppressive drugs pre- and post-transplant to ablate (destroy) the bone marrow. These are not recorded as therapeutic agents.
Peripheral Blood Stem Cell Transplantation (PBSCT): Rescue that uses peripheral blood stem cells to replace stem cells after conditioning.
Rescue: Rescue is the actual BMT or PBSCT done after conditioning.
Stem cells: Immature cells found in bone marrow, blood stream, placenta, and umbilical cords. The stem cells mature into blood cells.
Stem cell transplant: Procedure to replenish supply of healthy blood-forming cells. Also known as bone marrow transplant, PBSCT, or umbilical cord blood transplant, depending on the source of the stem cells. When stem cells are collected from bone marrow and transplanted into a patient, the procedure is known as a bone marrow transplant. If the transplanted stem cells came from the bloodstream, the procedure is called a peripheral blood stem cell transplant, sometimes shortened to stem cell transplant.
Umbilical cord stem cell transplant: Treatment with stem cells harvested from umbilical cord blood.
Coding Instructions
1. Assign code 00 when
a. The medical record states that there was no hematologic transplant or endocrine therapy, or these were not recommended, or not indicated
b. There is no information in the patient’s medical record about transplant procedure or endocrine therapy AND
i. It is known that transplant procedure or endocrine therapy is not usually performed for this type and/or stage of cancer
OR
ii. There is no reason to suspect that the patient would have had transplant procedure or endocrine therapy
c. The treatment plan offered multiple treatment options and the patient selected treatment that did not include transplant procedure or endocrine therapy
d. Patient elects to pursue no treatment following the discussion of transplant procedure or endocrine therapy. Discussion does not equal a recommendation. Patient's decision not to pursue transplant procedure or endocrine therapy is not a refusal of transplant procedure or endocrine therapy in this situation.
e. Active surveillance/watchful waiting is the first course of treatment (e.g., CLL)
f. Patient diagnosed at autopsy
2. Assign code 10 if the patient has a bone marrow transplant and it is unknown if autologous or allogeneic (BMT, NOS) or “mixed chimera transplant (mini-transplant or non- myeloablative transplant). These transplants are a mixture of the patient’s cells and donor cells.
3. Codes 11 (Bone marrow transplant autologous) and 12 (Bone marrow transplant allogeneic) have priority over code 10 (BMT, NOS)
4. Assign code 12 (allogeneic) for a syngeneic bone marrow transplant (from an identical twin) or for a transplant from any person other than the patient
5. Assign code 20 for
a. Allogeneic stem cell transplant
b. Peripheral blood stem cell transplant
c. Umbilical cord stem cell transplant (single or double)
Note: If the patient does not have a rescue, code the stem cell harvest as 88, (recommended, unknown if administered) or if harvested but unknown if infused.
6. Assign code 30 for endocrine radiation and/or surgery. Endocrine organs are testes and ovaries. Endocrine radiation and/or surgical procedures must be bilateral, or must remove the remaining paired organ for hormonal effect.
Note: Bilateral oophorectomy is coded 30 when it is performed for hormonal effect for breast, endometrial, vaginal, and other primary cancers.
7. Assign code 87 if the patient
a. Refused recommended transplant or endocrine procedure
b. Made a blanket refusal of all recommended treatment and the treatment coded in this data item is a customary option for the primary site/histology
c. Refused all treatment before any was recommended
8. Assign code 88 when
a. The only information available is that the patient was referred to an oncologist for consideration of hematologic transplant or endocrine procedure
b. A bone marrow or stem cell harvest was undertaken, but it was not followed by a rescue or reinfusion as part of first course treatment
Note: Review cases coded 88 periodically for later confirmation of transplant procedure or endocrine therapy.
9. Assign code 99 when there is no documentation that transplant procedure or endocrine therapy was recommended or performed
a. For death certificate only (DCO) cases