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Tumor Tip of the Week-Total Dose Multiple Metastatic Sites Treated Concurrently

Tumor Tip Of The Week-Total Dose Multiple Metastatic Sites Treated Concurrently

Scenario: Stage IV adenocarcinoma of the lung and multiple symptomatic sites of metastases:

  • 11/10/2018 to 11/21/2018. Treatment to thoracic spine, Unblocked photon field, 3000 cGy in 10 fractions
  • 11/12/2018 to 11/23/2018: Treatment to right femur, unblocked photon field, 3000 cGy in 10 fractions
  • 11/12/2018 to 11/16/2018: Left hip treated with conformal fields designed to spare adjacent bowel, bladder, and soft tissues. 2000 cGy in 5 equal fractions.
  • 11/12/2018 to 11/16/2018: Right humerus, open square field, 2000cGy in 5 equal fractions

Question: How do you code the Total Dose Field [total cumulative radiation dose administered to the patient across all phases during the first course of treatment.]?

  • 999999
  • 999998
  • 010000
  • 003000

Answer: 003000

Rationale:Record the maximum dose to first volume/phase. Do not add doses to different treatment volumes.

CTR Guide to Coding Radiation Therapy Treatment in the STORE Case Study # 7 Multiple Metastatic Sites Treated Concurrently.

­­­­­­­­­­­­­­­­­­­­­­­­­­­https://www.facs.org/~/media/files/quality%20programs/cancer/ncdb/case_studies_coding_radiation_treatment.ashx

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