potential information loss in HCPCS G9069, G9068 mapping

[dimshitc]

G9069|Oncology; disease status; small cell lung cancer, limited to small cell and combined small cell/non-small cell; extensive stage at diagnosis, metastatic, locally recurrent, or progressive (for use in a medicare-approved demonstration project)

loses the information on extensive stage at diagnosis

G9069|Oncology; disease status; limited to small cell and combined small cell/non-small cell; extent of disease initially established as limited with no evidence of disease progression, recurrence, or metastases (for use in a medicare-approved demonstration...

loses the NOT extensive stage at diagnosis

[cgreich]

Should be discussed at the Onco WG. "Extensive" and "not extensive" are not defined Cancer Modifiers. The OR list is not helpful, either. I am not sure this can be rescued in a meaningful way.

[vladkorsik]

Hi @dimshitc , @cgreich My thoughts on it:
OR statements make the G9069 definition unmappable altogether as it highlights a spectrum of LC behavior ranging from widespread at the time of initial diagnosis to recurrence patterns. It represents the 'Advanced' disease phenotype.
For G9068, this can potentially be mapped to the Limited Stage Modifier;

However, you have to somehow address the ETL issues with:
a) Dates assignments (as the code states the historical fact at the time of initial diagnosis).
b) Resolving staging conflicts (HCPCS vs. non-HCPCS).

Comment on (b): Сommunit wants to avoid Visits coming from CPT4 and HCPCS codes, but at the same time, it seems that you want to add some proxies for Cancer Stages. We have to be consistent.

[cgreich]

a) Date assignments (as the code states the historical fact at the time of initial diagnosis).

Not a big deal. The recording date does not have to be exactly on the day it became known. From a disease perspective, the date is unknown and unknowable anyway.

b) Resolving staging conflicts (HCPCS vs. non-HCPCS).

We have the Episodes for that. Their heuristic will do that. Only problem: We don't have such heuristic yet.