Using billing codes to count cancersSep. 2, 2021, 10:30 AM
by Paul Govern
The most common cancer in white people is keratinocyte cancer, a type of skin cancer. The number of keratinocyte cancers a patient has had figures in cancer risk assessment and prevention, but the inherent fragmentation of the U.S. health system, with records tending to be spread hither and yon, complicates the task of counting these cancers in patients over time.
Nimay Anand, Lee Wheless, MD, PhD, and colleagues asked which types of health care billing codes were most useful for counting skin cancers in individual patients in the context of a single institution (namely, Vanderbilt University Medical Center). Their report appears in JAMA Dermatology.
Counts from two commonly used code sets were compared to counts from pathology records, with Current Procedural Terminology codes emerging as the clear favorite, showing 87% correlation with pathology records for patients considered established at VUMC, compared to only 22% correlation of International Classification of Disease codes with pathology records of such patients.
Anand is a student at Meharry Medical College in Nashville. Also on the study from VUMC were LaVar Edwards, MS, Laura Baker, MD, MEd, and Mary-Margaret Chren, MD. The study was supported in part by the National Institutes of Health (TR000445), the Skin Cancer Foundation and the Dermatology Foundation.