Nearly twothirds of these patients are diagnosed at age 65 years or older, with an estimated median age at diagnosis of 70 years. A diagnostic accuracy study article pdf available in bmj open 85. In the neoplasm table, lungupper lobeprimary is 162. All cases of localized non small cell lung cancer reported to our state cancer registry between 1996 and 2002 were identified and linked to the inpatientoutpatient surgery files and 2000 census. Utility of administrative claims data for the study of. We identified medicare beneficiaries with primary non smallcell lung cancer nsclc, who underwent lobectomy or slr between 1 october 2007 and 30 june 2012, from the linked database. For claims with a date of service on or after october 1, 2015, use an equivalent icd10cm code or codes. For lung cancer, we will consider the icd9cm codes 162. In this study, we sought to determine the accuracy with which the international classification of diseases, 9th edition, clinical modification icd9cm diagnosis code for secondary neoplasm of brain and spinal cord in health insurance claims measures clinically evident central nervous system cns metastases in patients with non small cell lung cancer nsclc. Similar longterm survival of elderly patients with nonsmall cell lung cancer treated with lobectomy or wedge resection within the surveillance, epidemiology, and end results database. Introduction in patients with advanced stage iiibiv non smallcell lung cancer nsclc, platinumbased chemotherapy regimens have provided improvement in shortterm survival, symptom control, and quality of life. Non small cell lung cancer nsclc is usually diagnosed at advanced stage iiib or iv, when cure is rarely attainable.
Patients with stage iii nsclc have a 5year survival rate ranging from %36% 2, 46. Disparities in systemic treatment use in advancedstage. For noninvasive breast cancer, we will consider the icd9cm code. The california cancer registry was merged with the patient discharge data set to determine the incidence of vte among lung cancer cases diagnosed between 1993 and 1999. Approximately 40 % of all patients with non small cell lung cancer nsclc will develop brain metastasis during the course of their disease. The diagnostic accuracy of lung cancer was confirmed by both specific icd9cm codes and inclusion in the registry for catastrophic illness patient database. Procedural aggressiveness in veterans with advanced nonsmall. Validity of icd9cm codes for breast, lung and colorectal.
The masstumor is specified in the report as being in the upper lobe. Data were obtained on 101,844 incident non small cell lung cancer nsclc cases in the ccr during the period from 1989 to 2003 with tnm staging data and complete followup data available. Combined small cell lung carcinoma or csclc, and rarely rendered as smallcell lung carcinoma is a form of multiphasic lung cancer that is diagnosed by a pathologist when a malignant tumor arising from transformed cells originating in lung tissue contains a component of small cell lung carcinoma sclc admixed with one or more components of non small cell lung carcinoma nsclc. The cancer types were identified using icd9cm codes see table 1b.
The subjects were persons with a form of lung cancer for which surgical resection has been shown to confer a definitive benefit stage i or stage ii non smallcell lung cancer. A total of 222,500 new cases of lung cancer and 155,870 lung cancer deaths were estimated for 2017. When possible, they are primarily treated by surgical resection with curative intent, although chemotherapy has been used. Wholebrain radiation therapy wbrt with or without surgical resection has. Non small cell lung cancer nsclc is the leading cause of cancerrelated deaths in the usa, accounting for25 % of all cancerrelated deaths in both men and women 1. Underuse of surgical resection for localized, nonsmall cell. Costs of firstline doublet chemotherapy and lifetime medical care in advanced non smallcell lung cancer in the united states kathleen lang, phd,1,5 martin d. These years were chosen because many of the detailed icd9cm codes became available on 1 october 2007. Short version of 20 icd9cm casefinding list for reportable tumors codes and explanations. As a class, nsclcs are relatively insensitive to chemotherapy, compared to small cell carcinoma. Disparities in surgical treatmentof earlystage nonsmall. However, a high proportion of advancedstage patients are untreated. Utility of administrative claims data for the study of brain. Racial differences in the treatment of earlystage lung cancer.
Costs of firstline doublet chemotherapy and lifetime medical. Carboplatin and paclitaxel with vs without bevacizumab in. Non small cell lung cancer nsclc accounts for 80% to 85% of all lung cancer 222,500 new cases per year in the united states, and the predominant proportion of the patients 80% are ultimately diagnosed as stage iv disease. Regardless of the cell type, the icd 9 cm code for primary malignant neoplasm of the lung is 162. Between 50 and 80% of patients with lung cancer have copd, and recent estimates of lung cancer risk in copd have been as high as 167 per 10,000 personyears, substantially higher than the overall risk of 6. Icd9cm diagnosis and procedure codes for identifying the wedge resection procedures, cancer diagnoses, comorbid conditions, and all adverse events are listed in eappendixes 1 through 4. Eatonlambert syndrome due to small cell carcinoma of lung. Non small cell lung cancers include squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.
Pdf accuracy of lung cancer icd9cm codes in umbria. To identify nsclc from the overall lung cancer sample, patients receiving chemotherapy regimens characteristic of treatment for small cell lung cancer sclc were excluded. For earlystage nsclc, we measured receipt of surgical lung resection in the period 3 months before through 5 months after the lung cancer diagnosis month, as indicated in the seer registry data codes 1070, 90 andor the presence of claims with relevant icd9 procedure codes 32. However, to our knowledge, no modern trials have compared the most common treatments for nsclc. Downloadable files of diagnosis and procedure codes and their full and abbreviated titles are available in the downloads and related links. Time to initial cancer treatment in the united states and. Management of advancedstage nonsmall cell lung cancer nsclc has changed significantly over the past two decades with the development of numerous systemic treatments, including targeted therapies. Non small cell lung cancer nsclc accounts for 80%85% of all newly diagnosed lung cancer cases.
To compare overall survival of patients with diabetes with stage iv non small cell lung cancer nsclc taking metformin versus those not on metformin. Safety outcomes in advanced nonsmallcell lung cancer. The gems are the raw material from which providers, health information vendors and payers can. Tables 1 and 2 summarize patient characteristics and overall 5year survival across cancers. Icd9cm codes in identifying subjects with lung cancer. Bevacizumab for the treatment of nonsmall cell lung cancer. Because bevacizumab is used for non smallcell lung cancers, patients with smallcell or neuroendocrine lung cancer according to icdo3 histology codes were.
Genderbased impact of epidermal growth factor receptor. Nsclc patients present with stage iii disease in approximately one third of all cases, and of those cases, only a minority are considered surgically resectable 25. Despite treatmentrelated advances, the prognosis of lung cancer remains poor with a 5year survival rate of 4% in distantstage disease. Icd9 code 185 and icd10 code c61 are the diagnostic codes used for. Surgery of nsclcs includes wedge resection, sleeve lobectomy, lobectomy, and pneumonectomy if there is no. Costs of firstline doublet chemotherapy and lifetime. Pneumoconioses and other lung diseases due to external agents 500508. Non smallcell lung carcinoma nsclc is any type of epithelial lung cancer other than small cell lung carcinoma sclc. The most common form of the disease is non small cell lung cancer nsclc, which accounts for approximately 75%87% of all cases 2, 3. The influence of hospital volume on survival after. Is incentive spirometry beneficial for patients with lung.
The study population comprised 3,672,561 patients of whom 37. This type of lung cancer is more common than small cell. Usingdatafromthree populationbasedregistries inthenational cancer institutes surveillance, epidemiology and end results seer program, surgical treatment amongblack. This is a shortened version of the second chapter of the icd9. Marciniak, phd,2 douglas faries, phd,2 michael stokes, mph,1,4 don buesching, phd,2 craig earle, md, msc,3 joseph treat, md,2 steve babineaux, ms,2 nathalie morissette, msc,1 david thompson, phd1 1i3 innovus, medford, ma, usa. Bevacizumab for the treatment of nonsmall cell lung. Non small cell lung cancer nsclc is the most common type of lung cancer, accounting for approximately 80%85% of cases. Patients with a history of tobacco use icd9cm codes v15. With an estimated 222,500 newly diagnosed cases of lung cancer and 155,870 deaths expected in 2017, lung cancer represents the second most common cancer and the leading cause of cancer death in the united states. Plus supplementary lists of codes that are not reportable or neoplasmrelated. Approximately 20% of patients with non small cell lung cancer nsclc will develop brain metastases in their lifetime. Both volumes can be downloaded for free from the website of the world health. Among 91 933 patients with newly diagnosed lung cancer, the 1year and 2.
This study identified predictors of therapy and differences in overall survival os. Using data from the surveillance, epidemiology, and end results registry linked to medicare claims, we identified 750 patients with diabetes 6580 years of age diagnosed. This included 19,702 stage i, 3,753 stage ii, 10,429 stage iiia, 22,285 stage iiib, and 45,675 stage iv nsclc patients. Objective to determine clinical characteristics and survival outcomes. Accuracy of lung cancer icd9cm codes in umbria, napoli 3 sud and friuli venezia giulia administrative healthcare databases. Lung cancer is one of the leading causes of cancerrelated deaths in the world. Further studies are urgently needed to identify the patient, physician, and health systemrelated factors underlying these observations and optimize resection rates for non small cell lung cancer. The greatest sbm ip among patients with lung cancer was. Approximately 14% of new diagnoses are classified as having small cell lung cancer sclc, while the remaining 85% of cases are non small cell lung cancer nsclc. Icd9cm to icd10cm based on fy2014 icd9cm codes reportable neoplasms category and subcategory codes are shaded in grey and marked with an cells shaded in pink and marked with an indicate the preferred code when a single code maps to multiple codes see introduction reportable list. Survival from lung cancer is highly associated with lung resection surgery. The role that health insurance plays in receipt of systemic treatments is unclear. Malignant neoplasm of bronchus and lung, unspecified. Lung cancer harbored the highest incidence of brain metastasis in relation to all malignancies.
Importance the incidence of earlystage nonsmall cell lung cancer nsclc among the elderly is expected to rise dramatically owing to demographic trends and increased computed tomographic screening. Jun 27, 2009 in this study, we sought to determine the accuracy with which the international classification of diseases, 9th edition, clinical modification icd9cm diagnosis code for secondary neoplasm of brain and spinal cord in health insurance claims measures clinically evident central nervous system cns metastases in patients with non small cell lung cancer nsclc. Coding and billing for diagnosis and treatment of prostate cancer. Chronic obstructive pulmonary disease copd and lung cancer cause significant morbidity and mortality. Previous studies have indicated a high accuracy of the icd9cm diagnoses in the nhird 20, 21. We followed all patients until the first diagnosis of lc, withdrawal from the national health insurance program, or. At diagnosis, 70 % of patients have advanced or metastatic disease, and systemic chemotherapy is the main treatment modality employed to prolong survival 2. The patient selection process necessarily excluded patients who had a wedge resection by either method during this time period but in whom histology was benign. Nov, 2014 approximately 14% of new diagnoses are classified as having small cell lung cancer sclc, while the remaining 85% of cases are non small cell lung cancer nsclc. Realworld treatment patterns, overall survival, and. The latter index focuses on chronic illnesses such as congestive heart failure icd9cm codes 402 through 404, liver disease icd9cm code 572, and chronic obstructive pulmonary disease icd9. Methods this retrospective study included stage iii nsclc patients aged.
Budget impact analysis of afatinib for firstline treatment. Validity of icd9cm codes for breast, lung and colorectal cancers in. Underuse of surgical resection for localized, nonsmall. Diagnosis in the early stages provides the greatest chance for survival. Use of stereotactic radiosurgery for brain metastases from. Adapting a clinical comorbidity index for use with icd9cm administrative databases. These years were chosen because many of the detailed icd9cm codes.
The incidence of venous thromboembolism among patients. Non small cell lung cancers nsclcs are the most common types of lung cancers and have diverse pathological characteristics. Disparities in systemic treatment use in advancedstage non. To code a diagnosis of this type, you must use one of the three child codes of c34. Lung cancer remains the second most commonly diagnosed cancer in the united states us, with approximately 225,000 new cases and 160,000 deaths expected in 2014. Even with treatment, the prognosis for these patients remains poor with a median survival of 7 months.
Even with treatment, the prognosis for these patients remains poor, with a median survival of 7 months, although certain subgroups experience a median survival up to 15 months. Accuracy of lung cancer icd9cm codes in umbria, napoli 3. Non hodgkins lymphoma small cleaved cell, follicular non hodgkins lymphoma mixed small cleaved and large cell, follicular 202. Underuse of surgical resection for localized, non small cell lung cancer is a persistent problem, particularly among african americans. Sublobar resection for nodenegative lung cancer 25 cm in. Nov 28, 2019 because bevacizumab is used for non smallcell lung cancers, patients with smallcell or neuroendocrine lung cancer according to icdo3 histology codes were excluded from this analysis exclusion. Lung cancer is the leading cause of mortality in all patients with cancer, accounting for 14% of newly diagnosed cancer cases and 26% to 28% of all cancer deaths in the united states. Comparison of demographics, treatment patterns, health. American journal of respiratory and critical care medicine. Coders routinely download the most uptodate encoder software. Inhaled corticosteroids may prevent lung cancer in asthma. Non smallcell lung cancer nsclcb comprises 75 to 80 percent of all lung cancers, and about 30 percent of patients are candidates for curative surgical resection 1, 2. Equivalence map definitions the icd9 and icd10 gems are used to facilitate linking between the diagnosis codes in icd 9 cm and the new icd10cm code set.
The radiologist also notes a secondary diagnosis of coronary arteriosclerosis, there is no mention of prior bypass. Nearly twothirds of these patients are diagnosed at. Natural history of stage i nonsmall cell lung cancer chest. Lifetime occurrence of brain metastases arising from lung. The influence of hospital volume on survival after resection. Firstline treatment with bevacizumab and platinum doublet. Overview of tumors, cancer and oncology c00d48, 140239. Comparison of demographics, treatment patterns, health care. Comorbidity romanocharlson index was calculated using administrative data codes. Until the recent emergence of immune checkpoint inhibitors icis, platinumbased chemotherapy has been the gold standard for the firstline.
249 257 275 690 1297 1326 597 653 1337 1341 1340 765 816 927 430 1316 406 520 793 451 1428 320 1413 424 221 1181 782 1288 1472 13