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Code for cancer care review (To be added within 6 months of the cancer diagnosis, and within the last 15 months)

8BAV. Cancer care review

Cancer Diagnosis Codes (Diagnosed in previous 15 months)

B0... Malignant neoplasm of lip, oral cavity and pharynx
B00% Malignant neoplasm of lip
B01% Malignant neoplasm of tongue
B02% Malignant neoplasm of major salivary glands
B03% Malignant neoplasm of gum
B04% Malignant neoplasm of floor of mouth
B05% Malignant neoplasm of other and unspecified parts of mouth
B06% Malignant neoplasm of oropharynx
B07% Malignant neoplasm of nasopharynx
B08% Malignant neoplasm of hypopharynx
B0z% Malignant neoplasm of other and ill-defined sites within the lip, oral cavity and pharynx
B1% Malignant neoplasm of digestive organs and peritoneum
B2% Malignant neoplasm of respiratory tract and intrathoracic organs
B3... Malignant neoplasm of bone, connective tissue, skin and breast
B30% Malignant neoplasm of bone and articular cartilage
B31% Malignant neoplasm of connective and other soft tissue
B32% Malignant melanoma of skin
B34% Malignant neoplasm of female breast
B35% Malignant neoplasm of male breast
B36.. Local recurrence of malignant tumour of breast(v24)
B3y.. Malignant neoplasm of bone, connective tissue, skin and breast otherwise specified
B3z.. Malignant neoplasm of bone, connective tissue, skin and breast NOS
B4% Malignant neoplasm of genitourinary organ
B5% Malignant neoplasm of other and unspecified sites
B6% Malignant neoplasm of lymphatic and haemopoietic tissue (excluding B677. Myelodysplastic and myeloproliferative disease )
Byu.. [X]Additional neoplasm classification terms - Byu41 [X]Malignant melanoma of skin, unspecified
Byu0. [X]Malignant neoplasm of lip, oral cavity and pharynx
Byu1.% [X]Malignant neoplasm of digestive organs
Byu2.% [X]Malignant neoplasm of respiratory and intrathoracic organs
Byu3.% [X]Malignant neoplasm of bone and articular cartilage
Byu4. [X]Melanoma and other malignant neoplasms of skin
Byu40 [X]Malignant melanoma of other and unspecified parts of face
Byu41 [X]Malignant melanoma of skin, unspecified
Byu5.% [X]Malignant neoplasm of mesothelial and soft tissue - ByuE0 [X]Malignant neoplasms of independent (primary) multiple sites
Byu6. [X]Malignant neoplasm of breast
Byu7.% [X]Malignant neoplasm of female genital organs
Byu8.% [X]Malignant neoplasm of male genital organs
Byu9.% [X]Malignant neoplasm of urinary tract
ByuA.% [X]Malignant neoplasm of eye, brain and other parts of central nervous system
ByuB.% [X]Malignant neoplasm of thyroid and other endocrine glands
ByuC.% [X]Malignant neoplasm of ill-defined, secondary and unspecified sites
ByuD.% [X]Malignant neoplasms of lymphoid, haematopoietic and related tissue
ByuE. [X]Malignant neoplasms of independent (primary) multiple sites
ByuE0 [X]Malignant neoplasms of independent (primary) multiple sites
K1323 Acquired renal cyst with neoplastic change
K01w1 Drash syndrome
68W24 Bowel scope (flexible sigmoidoscopy) screen: cancer detected(v27)
C184. Multiple endocrine neoplasia syndrome type 1 (v27)

Cancer exception reporting codes (In last 12 months)

9h8.. Exception reporting: cancer quality indicators
9h81. Excepted from cancer quality indicators: Patient unsuitable
9h82. Excepted from cancer quality indicators: Informed dissent


CAN 003.1 Rationale

A GP will have an average of eight or nine new cancer diagnoses per year and will be looking after 20 to 30 patients with cancer. The increasing number of cancer survivors has led to an increase in the number of people requiring follow-up care, monitoring and management. From April 2014, practices are required to record that a patient review has occurred within six months of diagnosis to achieve this indicator. However, given the importance of primary care practitioners making early contact with patients who have been diagnosed with cancer, good practice would suggest that a review should occur between three to six months of diagnosis.

Most practices will see patients with a new cancer diagnosis following assessment and management in a secondary or tertiary care setting. These patients quickly resume consultations in general practice at an increased rate to pre-diagnosis and treatment, therefore primary care has an important role in managing survivorship. This review represents an initial opportunity to address patients’ needs for individual assessment, care planning and on-going support and information requirements.

A cancer review in primary care includes:

• The patient’s individual health and support needs, which will vary with, for example, the diagnosis, staging, age and pre-morbid health of the patient and their social support networks. In collaboration with the National Cancer Survivorship Initiative (NCSI), Macmillan primary care community has produced a template which recommends that this could cover a discussion of the diagnosis and recording of cancer therapy, an offer of relevant information, medication review, benefits counselling and recording of a carer’s details.

Macmillan primary care community template. http://www.ncsi.org.uk/wp-content/uploads/EMIS-guide-info.pdf

• The coordination of care between sectors.

Further information on survivorship and the potential role for primary care can be found on the NCSI website.

NCSI: http://www.ncsi.org.uk/what-we-are-doing/assessment-care-planning/cancer-care-review/

NCSI website. http://www.ncsi.org.uk/

It is preferable that a review should be face-to-face in most cases, making contact with a patient over the telephone will meet the requirements for this indicator. Where contact is made over the phone, an offer of a subsequent face-to-face review is advised.

CAN 003.2 Reporting and verification

See indicator wording for requirement criteria.

For the purposes of this indicator, the six month timeframe starts from the date of diagnosis irrespective of whether or not the diagnosis was made in primary care.

Verification NHS England may wish to review records where a review is claimed to confirm that the review has been completed within 6 months of diagnosis.


Prepared By Jean Keenan