SPRING 2016 NEWSLETTER
A Message from Jennifer Fielding, RHIT, CTR 2016-2018ArCRA President:
Hello ArCRA members! I hope you are enjoying this beautiful spring weather and are also getting geared up for summertime. I know I’m looking forward to flip flops, extra sunshine and grilling out. If anyone has a swimming pool and would like to have me over every weekend, I would not be sad about it.
We had a very successful combined ArCRA/ACCR meeting May 4-6 at the Hilton Garden Inn in North Little Rock. If you were unable to join us, please know that you were missed and we hope to see you at the next meeting! All of our speakers did a fantastic job and brought some new, interesting and vital information to ArCRA. It was great to see everyone and to get to visit on a personal and professional level.
Our next meeting is kind of up in the air right now. We may have another meeting this year in the fall, we may wait until 2017 to have our next annual meeting, or we may try to organize another regional meeting. Those that were able to attend the business meeting know that we are considering a partnership with the Central Registry for future meetings. While this is being hashed out, we won’t have any further details. I apologize for the vagueness and uncertainty but promise to keep everyone updated – when I know, you will know.
Speaking of meetings, I’d like to thank John Guire and his fabulous planning committee for the wonderful job they did in organizing our spring 2016 meeting. Hats off to Heather Morris, Renee Webb, Melissa Riddle, Amy Greer, and Teresa Williams! None of this is possible without volunteers who dedicate their time and energy into supporting ArCRA. Heather Morris will be heading up our next meeting so if you want to get in on the planning, be sure to let her know!
I attended the NCRA meeting in Las Vegas in Apriland it was a good one! There were so many enlightening sessions dealing with everything from radiation therapy coding guidelines to the impact of molecular and genetic testing of tumors. I sat in on the Registry Management breakout sessions and got a few great ideas for QA ofregistry data. (Please see Education Corner)
I also learned that Dianna Wilson likes to zip line over downtown Las Vegas!
It was a terrific conference and I was honored to represent Arkansas.
A new and improved updated membership list is now available on the ArCRA website so we can keep in contact with one another. If you (and please DO!) visit the website and see areas for improvement, please let me know via e-mail. I’ll try my best to keep all information current but I can’t promise perfection. I know – that’s a huge shocker!
Thanks again to all ArCRA members for your continued support, involvement and volunteerism in our association. We are nothing without all of us!
Jennifer Fielding, RHIT, CTR
2016 Annual Conference
The 40thArCRA/ACCR Educational Conference “CANCER REGISTRARS -DATA SUPERHEROES”
meeting took place at the Hilton Garden Inn in North Little RockMay 4-6.
Thirty-nine ArCRA/ACCR members were warmly welcomed to the conference and the meeting got underway with introductions and a whimsical discussion about what superpower each member would like to have. They ranged from the ability to put everyone on mute to having Bewitched-like superpowers to wrinkle the nose and have the entire house cleaned. We all enjoyed dreaming of how rich life would be if we could just be invisible or turn back time. After a little wishful thinking our meeting was underway. The sessions were full of useful information from beginning to end and left us with many “aha” moments.
Melissa Riddle, CTR, and Superhero Educator was introduced and we learned that looking at the “whole picture” means getting rid of ourblinders,looking at what steps we need to take to improve the quality of our data and asking ourselves what our career/professional goals are as we head into the future.
Melissa then walked us through abstracting breast, melanoma, and hematopoietic cases from beginning to end with the main focus on TNM and SEER staging along with treatment and overall information. Were we coding that right? She explained some of the most common mistakes and coding disasters and how to avoid them. She also clarified some of the newer treatments.
Carole Eberle, BS, CTR a Member of NCRA’s Education Committee shared with the members NCRA’s
“The Informational Abstract” A guide to assist registrars in preparing site specific abstracts by using an outline that has a specific sequence designed to maximize efficiency. It includes eight sections: history& physical, x-rays/scopes/scans,labs,diagnostic procedures,pathology,primary site, histology and treatment.
Leigh Ann Warriner, MMT gave a great talk on how she became an Oncology Massage Therapist. She alsowent through the four different levels of massage and the importance of coordinating with the patient’s other care takers to determine the level appropriate for each patient. It was very interesting, informative, and we could see how important it would be to a patient to have that personal touch that they don’t really get from other medical professionals.
Business Meeting
The 40th Annual Business Meeting was called to order by Jennifer Fielding, ArCRA President with recognition of the members of the Education and Program Planning Committee.
The membership count and quorum was reported by Anitta Schwander, CTR, ArCRA Secretary. The
meeting minutes from fall 2015 were approved. Kathy Fors, CTR, ArCRATreasurer distributed copies of the treasurer’s report and it was approved. There was no old business to discuss. The new business discussion involved a proposal that ACCR would give ArCRA funds annually and ArCRA would then be in charge of planning further educational meetings. At this time we are awaiting a contract from ACCR. The proposal was tabled for discussion until then.
Gigi White brought up the need for advocating for our profession and growing a skill set to get the necessary recognition at local, state and national levels. We discussed the importance of this in relation to receiving the compensation and salaries necessary to compete with other professions.
Committee Reports were then given by Mentoring Chair Heather Morris who would like our organization to connect with HIM Programs and Career Fairs to promote our profession. Amy Greer Ways and Means Chair reported that we had approximately $250 dollars in gift cards and a Kindle Fire donated for our raffle.Debra Reed, Scholarship Committee Chair reported that four Lucy Utterback Scholarships had been approved for members attending this education meeting
Theressia Mitchell was presented with the Williams Ross Award for her many years of dedication and service. Congratulations T!
ACCR Update: ACCR is in the process of hiring someone to fill John Guire’s position and the new liaison for ArCRA will be Abby Holt with help from Christy Bell.
Caught on Camera
Debra, Cynthia, Jen, and Gigimuggin’ for the paparazzi
Laurie Gibbs taking a break from the twins and learning stuff
Melody and Sue Ann showing the love
ArCRA Executive Committee - you put your trust in THIS??
ArCRA’S Super Hero mentors, motivators and educators
Here is what some members had to say about their
# CANCER REGISTRY SUPER HEROES
C
SUPER TEAMS
Jennifer, Debra, Heather VA TEAM, Team CARTI, Team Baptist, Team UAMS and ACCR and of course the members of ArCRA “all Cancer Data Super Heroes”
The Daboll family grew by two feet with the arrival of Charlotte on April 18th Congratulations!
Laura says Annabelle is thrilled to have a little sister
Laurie Gibbs’s Twins Hannah Caroline Victoria and Graham Thomas are growing up. They first arrived on December 13, 2013. Laurie says that Hannah really liked the “High Maintenance”hat that came in our welcome goodie bags
If you have pictures you want to share please send them to me and I will be happy to feature them in our next newsletter.
Gigi White and Lt Governor Tim Griffin 5/13/2016
Message from Gigi White Super CTR Promoter
During the ArCRA business meeting I stood up and tasked ArCRA members to be strong advocates for our profession and to get involved with issues related to cancer surveillance in our state. I encouraged everyone to write to their state representatives and use their connections/resources to bring awareness to poor compliance with the cancer reporting law and lack of competitive positions in AR for CTRs. Little did I know that I would be given an opportunity to practice what I preached! The attached photo of me with our Lt. Gov. Tim Griffin was taken May 13, 2016 in my small town, Carlisle AR. A friend of mine used to work for him and invited him to Carlisle High School for career day. I had spoken to her several times about our profession and cancer surveillance/control issues and she got me a quick meeting with him at our local barber shop (also happens to be our town mayor ). There I was – bumping elbows with half the towns farmers/business men, just waiting for my turn to meet with him. All in all, I think I did a really good job of explaining the issues. He was very gracious, attentive and seemed genuinely concerned with what I had to say. He and his staff gave me their business cards and asked me to follow up with additional information by email. Yes, I was so nervous but it was more related to the sheer amount of information I wanted share rather than just meeting him in that small setting. I’m proud of myself for getting out of yoga pants and making the effort FOR ALL OF US! I hope you’ll do the same if ever given the opportunity. #CTRsuperhero
RECRUITING MENTORS FOR ArCRA
Do you remember when you were a new registrar? Think about the registrars who trained, mentored, or encouraged you in your early registry months (years?). You know how much you appreciate that person or people, right? Maybe you’ve even taken that step of mentoring a new registrar already in your career. Maybe you’ve had friends, relatives, or random strangers ask, “Hey, how can I become a Cancer Registrar like you?”ArCRA has a vision for putting together a Recruiting and Mentoring Team to answer the need for both of these areas. There are multiple possible roles on this team, and you are all invited to be on the team!
Role 1 = Sign up as potential mentor.
Role 2 = Sign up to help with recruitment efforts at various schools/meetings around the state geographically.
Role 3 = Sign up to be an idea or administrative person.
Role 4 = Sign up to make contact with various schools/organizations to arrange for ArCRA to come speak to them.
Role 5 = Sign up to be a liaison between the ArCRA Mentoring team and the NCRA mentoring team.
Role 6 = ??? You may think of another role we need filled.
The goal of this team will be to reach out to new potential registrars and then mentor them as they move toward their CTR certification and actually start working in the registry field. We hope to get a pool of potential mentors who can be paired with new registrars OR registrars who are new to the state of Arkansas. You do not have to live geographically close to this person. Most of our mentoring will take place via phone and email. Please contact Heather Morris with any ideas or questions you may have. Heather can be reached via email at or by cell/text at 501.303.0758.
Long Timers Club
Members with 20+ years in ArCRA*
Linda Erkman - 33 years
Donna Laster – 33 years
Angie Waddles – 31 years
Pat Overton – 31 years
Kathy Wright – 26 years
Dianne Ketchum – 26 years
Pat Coke – 24 years
Kathy Trawick – 21 years
Cissy Carrigan – 21 years
Cheryl McNeil - 21 years
*based “year joined” listed on membership form
Thank you for your years of dedication and service to ArCRA!
EDUCATION CORNER
QA Ideas
- XRT treatment modality – check codes 20-27 to determine whether they can be “upgraded” to a 31 or 32
20 External beam, NOS
21 Orth voltage
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)
31IMRT
32 Conformal or 3-D therapy
- Review unknown primaries to see if more definitive site has been determined
- Mesothelioma (9050-9055) should be coded to primary sites: C38.0, C38.4, C38.8, C48.0, or C48.8
- Papillary thyroid carcinoma should be coded to 8260/3 (papillary adenocarcinoma
- Kidney primaries should never be coded to transitional cell carcinoma. Primary site would be renal pelvis
Coding treatment=Coding Disasterstip “Have a Plan and when disaster occurs work that plan”
SURGERY
CODING SDSP VS SURGERY
SDSP=DIAGNOSTIC Code diagnostic bx preceding excisional biopsy or surgical event Incisional biopsy Margins not evaluable (not mentioned) Excisional biopsy: Margins MACROscopic involved or unknown
SURGERY:
Excisional biopsy: Margins negative or MICROscopic involved
Margins must be examined to determine if intention was incisional or excisional bx
CASE EXAMPLE 12/28/14 L BREAST US: 9mm solid density UOQ suspicious biopsy recommended
1/10/15 L breast needle biopsy: Invasive ductal carcinoma grade 2. No in situ disease seen.
1/27/15 L breast lumpectomy: No residual invasive carcinoma seen
QUESTION: Is the 1/10/15 procedure coded as a SDSP or Surgery?
Is the 1/27/15 procedure coded as sugery, if so what type?
ANSWER 1/10/15 would be coded as a SDSP (02)
1/27/15 would be coded as surgery (22)
Re-Excision Code * Not to be used following a diagnostic biopsy onlyuse after a definitive surgical procedure fails to remove the tumor. This code can be used to run re-excision rate reports and you do not want to artificially inflate that number.
Systemic Treatment what should you include in your abstract
Chemotherapy: Code the accurate number of agents. Chemoembolization codes are based on the number of agents administered. Combination Regimens *Only the original agent or regimen is recorded as first course therapy
USE SEER RX to determine: Category #Subcategory # Usual primary sites # and whether to code
Hormone Therapy
Prednisone is coded when given w/chemotherapy regimen *CHOP*
Thyroid Replacement Therapy *Inhibits TSH-Synthroid
Immunotherapy: Alter the patient’s immune system or host’s response to tumor cells 2013 DRUG CATEGORY CHANGE
DRUG / PRE-2013 / 2013 FORWARDALEMTUZUMAB/CAMPATH / CHEMO / IMMUNO
Bevacizumab/Avastin / Chemo / Immuno
Rituzimab/Rituxan / Chemo / Immuno
Trastuzumab/Herceptin / Chemo / Immuno
Pertuzumab/Perjeta / Chemo / Immuno
Certuzumab/Erbitux / Chemo / Immuno
Congratulations to Kathy Fors, David Couch and Kim Nunez for passing the CTR!! Way to go!!
Be sure to check the ArCRA website for updates and if you have anything you would like to add or share with your fellow members please e-mail Jennifer Fielding or Anitta Schwander. Email addresses are on ArCRA’s website.
Thank You’s!!!
Thank you to Electronic Registry Systems for their generous donation and support!
Thank you to Elekta for your continued support of ArCRA!
Thank you to MedPartners for their generous gift card giveaway!
Thanks to ACCR for continued support and awesome partnership!
Thank you to all ArCRA members for being so awesome!