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MRA Thought of the Day – What’s New in 2013?

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Elizabeth R. Patena, M.D., CTR Vice President of Cancer Registry

Elizabeth R. Patena, M.D., CTR
Vice President of Cancer Registry

Changes in 2013: What’s new in 2013?

Three sets of new data items are added for 2013: Country, Secondary Diagnoses, and Over-rides for CS 1-19. For now, let’s focus on the new items that identify Country.

The three new items that identifies country:

  • Address at DX-Country
  • Address Current-Country
  • Birthplace-Country

Address at DX-Country identifies the country of the patient’s residence at the time of diagnosis. The codes are based on International Organization for Standardization (ISO) 3166-1 alpha-3 country codes, with some custom codes. This item was first defined for use in 2013. Cases diagnosed prior to 2013 should be converted automatically by the registry’s software.

The majority of your cases will have been diagnosed here in the US, therefore code Address at DX-Country to USA. If diagnosed in Canada, code as CAN. For countries other than the US and Canada, use the FORDS 2013; Appendix E as a reference for a list of country codes. The new Appendix E also provides the respective state codes for each country, including USA and Canada.

The same rule applies to Address Current-Country which identifies the country of patient’s current address.

Birthplace-Country identifies the country where the patient is born. Unfortunately, birthplace is one data item that is not always readily available in the medical records. If there is no doubt that the patient is born in the US, but State is unknown, code as USA. Even if the patient is of white race and of non-hispanic ethnicity, do not assume that Birthplace-Country is USA. Watch out also for patients with Spanish Surname Only. The Birthplace-Country is most likely not USA. If Birthplace is unknown, code Birthplace-Country as ZZU. Since most of the time the Birthplace is unknown, most of your cases will be ZZU for unknown country of birth.

Also worth discussing is Place of Birth. The former Place of Birth is replaced with Birthplace-State (NAACCR Item #252), and some applicable codes have changed. This data item records the patient’s state of birth. The new Appendix E is also the reference to use for state and associated country codes.

If Birthplace-State is known, use the USPS code for the State. Use Code XX if patient is born in a country other than the US or Canada, and the country is known. Use Code YY if born in a country other than the US or Canada, and the country is unknown. Use Code US if born in the US (including its territories, commonwealths, or possessions), and the State is unknown. Use Code ZZ if the birthplace is unknown and/or not mentioned in the patient record.

In summary:

Birthplace-State

Code XX

If patient is born in a country other than the US or Canada and the country is known.

Code YY

If patient is born in a country other than the US or Canada and the country is unknown.

Code US

If patient is born in the US, including its territories, commonwealths, or possessions, and the State is unknown.

Code CD

If patient is born in Canada and the province is unknown.

Code ZZ

If the birthplace is unknown, not mentioned in the patient record

 

Birthplace-Country

Code USA

United States

Code CAN

Canada

Code ZZU

If the birthplace is unknown, not mentioned in the patient record

What are your thoughts?

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