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 boost dose to the primary volume of interest during the first course of treatment. The CCR requires the collection of this data item.
Radiation – Boost RX Modality and Radiation-Regional RX Modality are converted to generate the RX Summ-Radiation.
External beam boosts may consist of two or more successive phases with progressively smaller fields generally coded as a single entity.
If multiple radiation therapy boost modalities are used to treat the patient, code the dominant modality.
Referral to a radiation oncologist is considered a recommendation for cases diagnosed January 1, 2010 and forward. Follow-up on these cases is required to determine whether radiation was administered or not, and code accordingly.
Referral does not equal a recommendation for cases diagnosed on or before December 31, 2009.
Boost RX Modality types include:
External beam fields of reduced size (relative to the regional treatment fields)
Implants
Stereotactic Radiosurgery
Conformal Therapy
IMRT
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. |