Reportability | Leukemia Cutis
Leukemia Cutis is the rare infiltration of neoplastic leukocytes into the epidermis, dermis, or subcutis from an existing leukemia that results in clinically identifiable cutaneous lesions. Leukemia cutis may precede, follow, or occur concurrently with the diagnosis of systemic leukemia. It is an advanced phase of leukemia with a poor prognosis that also strongly correlates with additional sites of extramedullary involvement. This can alter the appropriate treatment regimen for a patient. It is a type of “metastasis” or spread of the leukemia cells. The “conventional” definition for leukemia cutis is skin infiltration from a bone marrow primary. It is most often diagnosed via skin biopsy (i.e. punch, shave, etc) utilizing IHC/biomarker testing and is commonly associated with CMML & AML.
As such, it is a reportable condition especially when preceding a confirmed systemic leukemia diagnosis. In this situation, the diagnosis date would be the date of the positive Leukemia cutis skin bx (punch, shave, etc). The case should be coded to C421; 9800/3 Leukemia NOS until the official systemic leukemia diagnosis is rendered. If possible, follow-up on the case should be conducted to determine the specific systemic leukemia histology (CMML or AML) and the treatment received.
Suppose the Leukemia cutis follows or occurs concurrently with the diagnosis of systemic leukemia. In that case, it is NOT considered a separate primary, but merely an advanced stage of the systemic leukemia diagnosis.
Jennifer Ruhl, of SEER, has reviewed the coding guidance above and will add it to the next revision of the SEER Hematopoietic and Lymphoid Neoplasm Database. This will ensure that all registrars know how to code this condition when it presents itself.
References:
2023 SEER Workshop Material Available
This year’s SEER Workshop was excellent in providing lots of information on the new Toronto Staging for pediatric cancers (mandatory collection slated for 2025), 2024 SPCSM changes; Cancer PathCHART, LAMN/HAMN, Bile duct anatomy, H&N HPV histologies, Inter-& Extrahepatic Bile Duct Anatomy, and Brain & other STR sites. As a result, the LTR would like to share several of the PowerPoint presentation slides with LCRA members as they make excellent references for these specific topics.
2024 SPCSM Changes
Cancer PathCHART
Toronto Staging & the PDCS
Updates on HPV Related Head & Neck Carcinoma Pathology
2023 SEER*Educate Brain & Other Sites
• Handouts | Slides
Biliary
• Accurate Staging & Diagnosis
Appendiceal Mucinous Neoplasms
• Diagnosis Staging Outcomes
Extra/Intrahepatic Bile Ducts & Liver
• Anatomy & Primary Site
LAMN & HAMN Coding
• Handouts | Slides
• Appendix Anatomy
• Determining Behavior & Histology
• EOD SS2018
Oropharynx
• Anatomy & Primary Site
• HPV-Related Histology Coding
• SSDIs, Schema Discriminators & SEER SSF1
Free Training for Louisiana Registrars
LTR’s FLccSC Training Materials:
FREE CEs are available to all state reporters via LTR’s E-Learning system, FLccSC. Please visit the LTR Website and click on the FLccSC logo to view the short instructional video that provides access & user info. *Registration is required for access.
Live viewing:
To see if it is available in your area, contact your LTR Regional Coordinator.
Recorded viewing:
Please complete the NAACCR Webinar Series & Request Form
*All recorded viewing participants must follow LTR’s Procedure for Receiving CE Credit for Recorded NAACCR Webinar Viewing in order to receive credit from NCRA.
2021-2023 NEW FLccSC Courses Added:
Several NEW courses have been added to FLccSC. The newly added courses include: (*these webinars in particular contain extremely important information.)
NAACCR 2021-2022 Webinar Series:
- DATA ITEM RELATIONSHIPS 2022**
- BACK TO THE FUTURE – What Year Is It, and What Did I Miss? *CoC Standards Compliance
- SOLID TUMOR RULES
- CODING PITFALLS 2022**
NAACCR 2022-2023 Webinar Series:
- BREAST – Part 1 & 2**
- ESOPHAGUS
- HEAD & NECK
- DATA ITEM RELATIONSHIPS 2023**
- BOOT CAMP 2023
- PROSTATE 2023
- LOWER GI 2023 – Part 1
- LOWER GI 2023 – Part 2
- MELANOMA 2023
- It Worked For Me In-FUN-matics in the Cancer Registry (CoC Specific)
- Coding Pitfalls 2023
NAACCR Update Implementation Webinars:
- v23 Update: ICD O, Solid Tumor Rules, SSDI**
- Cancer PathCHART: CANCER Pathology Coding Histology & Registration Terminology
NAACCR 2023-2024 Webinar Series:
- LUNG – PART 1
- LUNG – PART 2
- RADIOLOGY & RADIATION (R&R)
- LIVER & BILE DUCTS
- PANCREAS
- BOOT CAMPS 1 & 2
- OVARY
- THYROID
- CNS
- Life in a CoC-Accredited Facility in 2024
- Coding Pitfalls
NEW
V24 Update: ICD O, Solid Tumor Rules, SSDIs & Surgery Codes *very important!
2023-2024 NAACCR Webinar Series:
• Radiology and Radiation (R&R)
• Liver and Bile Ducts
• Pancreas *Newly Added
• Boot Camp Parts 1 & 2 *Newly Added
*As a reminder, LTR’s FLccSC training materials, which provide FREE CEUs where indicated, are available FREE to all state reporters who submit cases to the LTR. If you have not registered for FLccSC and would like more information, please visit the LTR Website, and click on the FLccSC logo to view a short instructional access video. Happy viewing!
IMPORTANT UPDATE Webinar CE Expiration Date Changes
Initially, NAACCR webinars expired 2yrs s/p the LIVE air date for each webinar making things a bit complicated. To simplify things, NCRA has agreed to allow ALL NAACCR webinars in a series to have the SAME expiration date which is NOW 2yrs s/p the date of the LAST LIVE webinar to air in the series. As a result, FLccSC has been updated with NEW expiration dates to reflect this change.
SEER*Educate
Online training platform for current, new, and/or prospective cancer registry professionals provides FREE training to assist you in the following:
- Preparing for the ODS Exam
- Earning Continuing Education Credits (CEs) by scoring a minimum of 70% on all case coding exercises in a site group.
*You may retake coding exercises as many times as necessary. - Learning NEW coding schemes and guidelines by training on real-life case scenarios
- Helps improve individual performance and increase your facility’s data quality
- System requirements include a computer using the web browser Mozilla Firefox
New content is added quarterly. Current and future content include:
- Medical Terminology
- Statistics
- Computer Principles
- Commission on Cancer Standards
- Real-life case scenarios using CSv02.05
- Practice cases for the 2014 Hematopoietic & Lymphoid Database and Manual
- Cancer Program Management Principles and Practices textbook (April 2014)
- Anatomy (July 2014)
Sign up at SEER*Educate today and start learning by doing! Get started now with a demonstration exercise. Everyone who signs up will be notified quarterly about the release of new content.
SEER*Educate is funded by the Surveillance, Epidemiology, and End Results (SEER) of the National Cancer Institute (NCI) and the Fred Hutchinson Cancer Research Center.
ODS Certification Information
In preparation for the exam, please access the NCRA websites listed below. The main website contains current exam dates, as well as important information on documents used in preparing for the exam including what editions of the FORDS, SPCSM, CS, AJCC, and CoC Standards, will be included on the exam. The ODS exam testing centers are also listed as well.
Words of Wisdom for our ODSs:
“The well prepared create their own luck and resultant success; while those that fail to prepare, only prepare to fail.”
Lisa A.Pareti, BS, RHIT, ODS-C • LCRA Education Chair
“Recipe for successful passing of the ODS exam: study while others are sleeping, work while others are loafing, prepare while others are playing, and dream while others are wishing.”
William A. Ward
ODS Certification Exam Scholarship
LCRA awards one scholarship to a member in good standing who is eligible to sit for the ODS exam through the Gail Beebower Scholarship Fund. The stipend is provided for the certification exam fee only. Recipients cannot have any other source of test fee funding or reimbursement for taking the exam. The scholarship will be granted only once to each recipient. For more information, please click on the scholarship form below.
LCRA ODS Exam Scholarship Application Form
Those members wishing to contribute to the fund can contact Lisa Pareti at lparet@lsuhsc.edu for additional information.
NAACCR ODS Prep & Review
The NAACCR ODS Prep and Review Series starts Tuesday, August 22, 2023. They will meet every Tuesday for two hours for 8 weeks, and the final session is the Tuesday before the testing window opens. Each session is recorded and available for review until after the testing window closes. They have quizzes after each session and a timed practice exam during the last session. For more information or to register, click HERE.
The first webinar of the NAACCR Webinar series is Thursday, October 5, 2023. They have a great lineup this year! For more information or to subscribe, click HERE.
*Note: prices have increased this year.
For requests to post additional educational material,
send info to Casey Walker at cwalker.rhit@gmail.com.