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National Cancer Data Base
An Update on Assigning Class of Case

Over the last two or three years, a substantial number of hospitals either have purchased physician practices or have begun to hire physicians. The physician or practice is now part of the hospital. Under these circumstances, diagnosis and first-course treatment performed by those physicians are coded as having been done by the hospital.

  • Hospital A purchased an oncology clinic to provide service to patients living some distance from the main hospital location. Patients who receive first-course treatment in the clinic must be abstracted as having treatment “in the reporting facility” as analytic Class of Case 11-14 or 21-22.
  • Hospital B has several dozen physician practices spread across a large metropolitan area; the physicians are employed by the hospital. All diagnosis and first-course treatment provided by these physicians must be abstracted as part of the hospital’s care (analytic Class of Case 00, 11-14, or 21-22).

The examples above illustrate that the geographic location of hospital-employed physicians does not determine Class of Case. Similarly, a practice or clinic that is not owned by the hospital but which rents space within its walls is considered “elsewhere” when patients are diagnosed or receive first course treatment there.

  • An independent radiology clinic rents space from Hospital C and provides both diagnostic scans and radiotherapy treatment for many of Hospital C’s patients. Patients who receive care at the clinic must be abstracted by Hospital C only if the patient also receives care from the hospital itself. All care given by the clinic is “elsewhere” for the purposes of assigning Class of Case. If the program wishes to abstract cases that never receive care from the hospital, those cases are assigned an appropriate non-analytic Class of Case (usually 42).

The term “staff physician” is used to refer to independent physicians who have routine admitting privileges at the hospital.

  • Patients who are diagnosed in the physician’s office by a physician who has routine practice privileges in a hospital and then receive first-course treatment from the hospital itself are abstracted as Class of Case 11 or 12, “initial diagnosis in a staff physician’s office….” If the program wishes to abstract cases seen by staff physicians that never receive care from the hospital, those cases are assigned an appropriate non-analytic Class of Case (usually 40-41).

There are a number of ways to determine whether a clinic or physician practice is part of the hospital.

  • Does the hospital own the medical records for the practice?
  • Does the hospital’s accrediting organization (for example, The Joint Commission) identify the practice as a single entity with the hospital or as separate from it?
  • If all else fails, ask your cancer committee or hospital administration what the relationship is.

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December 7, 2012
In This Issue
CoC News
CoC Hospital Locator Update Scheduled for January 2013
Staff Contacts Needed in CoC Datalinks
Acccreditation Program
Many Accredited Programs Are Using the Survey Application Record: Is Your Program?
Resources to Support the Patient Navigation Standard
NewsCLiPs: News for Cancer Liaison Physicians
Completing the Cancer Liaison Physician Activity Report
Appointing or Reappointing a Cancer Liaison Physician Made Easy with CoC Datalinks
National Cancer Data Base
Assess Edits for the 2013 NCDB Call for Data
An Update on Assigning Class of Case
Educational Activities
Are You Caught Up On The Latest Education to Support the New Standards?
SAVE THE DATE for Survey Savvy 2013!
News from CoC Partners
New American College of Surgeons Patient Education Website
American Cancer Society News
Monthly Spotlight
Monthly Spotlight: American College of Physicians
ACE Newsletter: November 2012
News of Interest
NCI Launches Redesigned AccrualNet Website
Training Nurses and Program Administrators to Implement Cancer Clinical Trials
Central Brain Tumor Registry of the United States
Joint International Oncology Congress
ACP Launches 16th Edition of MKSAP
Upcoming Programs
Current On-Demand Webinars
NEW! Cancer Programs Standards 2012 Continuum of Care Services: Standard 3.1 Patient Navigation Process

Cancer Clinical Trials

Cancer Program Standards 2012 Chapter 1: Focus on Roles and Responsibilities of the Cancer Committee

Eligibility Requirements: The Cancer Committee's Role in Evaluation and Reporting

2012 and Beyond: The Survey Process

Studies of Quality and Quality Improvements

Quality of Patient Care: New CoC Standards

Important Accreditation Facts: New Program Categories, Accreditation Awards, and the OAA

Cancer Program Standards 2012 Continuum of Care Services: Focus on Survivorship Care Plans

Assuring a High-Quality Registry to Support Patient-Centered Care

Cancer Program Standards 2012 Continuum of Care Services: Focus on Psychosocial Distress Screening, Tools and Resources

Cancer Program Standards 2012: Clinical Services: Focus on Palliative Care Services

Cancer Risk Assessment and Genetic Testing

The College of American Pathologists (CAP) Cancer Protocols: Where Weve Been and Where Were Going

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