California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures for Hospitals
Record the dominant modality of radiation therapy used to deliver the most clinically significant regional dose to the primary volume of interest during the first course of treatment. The CCR requires the collection of this field. This data item and Radiation-Boost RX Modality are converted to generate the RX Summ-Radiation.
Radioembolization is embolization combined with injection of small radioactive beads or coils into an organ or tumor. Code Radiation Modality as brachytherapy, code 50, when tumor embolization is performed using a radioactive agent or radioactive seeds.
Code I-125 treatment for prostate cancer to brachytherapy, low dose radiotherapy (LDR), code 53.
The codes are:
Code |
Description |
00 |
No radiation treatment; diagnosed at autopsy |
20 |
External beam, NOS |
21 |
Orthovoltage |
22 |
Cobalt-60, Cesium-137 |
23 |
Photons (2-5 mv) |
24 |
Photons (6-10 mv) |
25 |
Photons (11-19 mv) |
26 |
Photons (>19 mv) |
27 |
Photons (mixed energies) |
28 |
Electrons |
29 |
Photons and electrons mixed |
30 |
Neutrons, with or without photons/electrons |
31 |
IMRT |
32 |
Conformal or 3-D therapy |
40 |
Protons |
41 |
Stereotactic radiosurgery, NOS |
42 |
Linac radiosurgery |
43 |
Gamma knife |
50 |
Brachytherapy, NOS |
51 |
Brachytherapy, intracavitary, LDR |
52 |
Brachytherapy, intracavitary, HDR |
53 |
Brachytherapy, interstitial, LDR |
54 |
Brachytherapy, interstitial, HDR |
55 |
Radium |
60 |
Radioisotopes, NOS |
61 |
Strontium-89 |
62 |
Strontium-90 |
98 |
Other, NOS |
99 |
Unknown; death certificate only |
Clarification: Intracavitary use of Cobalt-60 or Cesium-137 should be coded as 50 or 51. (See FORDS Manual for code definitions).
There is no hierarchy for this data item. If multiple radiation therapy modalities are used to treat the patient, code the dominant modality. In the rare occasion where 2 modalities are combined in a single volume (IMRT photons with an electron "patch" for example), code the appropriate radiation modality item to the highest level of complexity, i.e. the IMRT.
For cases diagnosed January 1, 2010 and forward, referral to a radiation oncologist is considered a recommendation. Follow-up on these cases is required to determine whether radiation was administered or not, and code accordingly.
Prior to January 1, 2010, referral does not equal a recommendation.
*Note: For cases diagnosed prior to January 1, 2003, the codes reported in this data item describe any radiation administered to the patient as part or all of the first course of therapy. Codes 80 and 85 describe specific converted descriptions of radiation therapy coded according to Vol. II, ROADS, and DAM rules and should not be used to record regional radiation for cases diagnosed on or later than January 1, 2003.