California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures
Record the dominant modality of radiation therapy used to deliver the most clinically significant regional RX Modality dose to the primary volume of interest during the first course of treatment. The CCR requires the collection of this data item.
Radiation - Regional RX Modality and Radiation - Boost RX Modality are required to code first course radiation therapy and are converted to generate RX Summ-Radiation.
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.
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. This applies to cases diagnosed January 1, 2010 and forward.
Referral does not equal a recommendation for cases diagnosed on or before December 31, 2009.
Use code 50 when tumor embolization is performed using a radioactive agent or radioactive seeds.
Use codes 50 or 51 for the use of Cobalt-60 or Cesium-137. (See FORDS Manual for code definitions).
Use code 53 for I-125 treatment for prostate cancer to brachytherapy, low dose radiotherapy (LDR).
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.
The field "Radiation Therapy at this Reporting Facility" is no longer be required by the CCR beginning with cases diagnosed 01/01/2003.
Code |
Label |
Definition |
00 |
No boost treatment |
A boost dose was not administered to the patient. Diagnosed at autopsy. |
20 |
External beam, NOS |
The treatment is known to be by external beam, but there is insufficient information to determine the specific modality. |
21 |
Orthovoltage |
External beam therapy administered using equipment with a maximum energy of less than one (1) million volts (MV). Orthovoltage energies are typically expressed in units of kilovolts (KV). |
22 |
Cobalt-60, Cesium-137 |
External beam therapy using a machine containing either a Cobalt-60 or Cesium-137 source. Intracavitary use of these sources is coded either 50 or 51. |
23 |
Photons (2-5 mv) |
External beam therapy using a photon producing machine with beam energy in the range of 2-5 MV. |
24 |
Photons (6-10 mv) |
External beam therapy using a photon producing machine with beam energy in the range of 6-10 MV. |
25 |
Photons (11-19 mv) |
External beam therapy using a photon producing machine with beam energy in the range of 11-19 MV. |
26 |
Photons (>19 mv) |
External beam therapy using a photon producing machine with beam energy of more than 19 MV. |
27 |
Photons (mixed energies) |
External beam therapy using more than one energy over the course of treatment. |
28 |
Electrons |
Treatment delivered by electron beam. |
29 |
Photons and electrons mixed |
Treatment delivered using a combination of photon and electron beams. |
30 |
Neutrons, with or without photons/electrons |
Treatment delivered using neutron beam. |
31 |
IMRT |
Intensity modulated radiation therapy, an external beam technique that should be clearly stated in the patient record. |
32 |
Conformal or 3-D therapy |
An external beam technique using multiple, fixed portals shaped to conform to a defined target volume. Should be clearly described as conformal or 3-D therapy in patient record. |
40 |
Protons |
Treatment delivered using proton therapy. |
41 |
Stereotactic radiosurgery, NOS |
Treatment delivered using stereotactic radiosurgery, type not specified in patient record. |
42 |
Linac radiosurgery |
Treatment categorized as using stereotactic technique delivered with a linear accelerator. |
43 |
Gamma knife |
Treatment categorized as using stereotactic technique delivered using a Gamma Knife machine. |
50 |
Brachytherapy, NOS |
Brachytherapy, interstitial implants, molds, seeds, needles, Radioembolization, or intracavitary applicators or radioactive materials not otherwise specified. |
51 |
Brachytherapy, intracavitary, LDR |
Intracavitary (no direct insertion into tissues) radioisotope treatment using low dose rate applicators and isotopes (Cesium-137, Fletcher applicator). |
52 |
Brachytherapy, intracavitary, HDR |
Intracavitary (no direct insertion into tissues) radioisotope treatment using high dose rate after-loading applicators and isotopes. |
53 |
Brachytherapy, interstitial, LDR |
Interstitial (direct insertion into tissues) radioisotope treatment using low dose rate sources. |
54 |
Brachytherapy, interstitial, HDR |
Interstitial (direct insertion into tissues) radioisotope treatment using high dose rate sources. |
55 |
Radium |
Infrequently used for low dose rate (LDR) interstitial and intracavitary therapy. |
60 |
Radioisotopes, NOS |
Iodine-131, Phosphorus-32, etc. |
61 |
Strontium-89 |
Treatment primarily by intravenous routes for bone metastases. |
62 |
Strontium-90 |
Strontium-90 |
98 |
Other, NOS |
Radiation therapy administered, but the treatment modality is not specified or is unknown. |
99 |
Unknown; death certificate only |
It is unknown whether radiation therapy was administered. Death certificate only. |