Coding FNA in the Diagnostic Confirmation field for FCDS
Based on recent Quality Control visual reviews of abstracts, coding an FNA in the Diagnostic Confirmation field and what is required by CoC in the Surgical Diagnostic and Staging Procedure data item is causing confusion.
An FNA is not considered cytology for reporting to FCDS, and the Diagnostic Confirmation data item should be coded to 1 when an FNA is performed.
Code 1 should be used when the microscopic diagnosis is derived from tissue samples taken during biopsy, frozen section, surgery, autopsy, D&C, or bone marrow aspirates. This is the correct coding for Fine Needle Aspiration (FNA). Pathologists may refer to FNA as ‘FNA Cytology.' However, 'cytology' for cancer registry purposes pertains to cells found in bodily fluids such as washings, spinal fluid, pleural fluid, or peritoneal fluid.
Code 2 is assigned when the microscopic diagnosis is based on the cytologic examination of cells suspended in body fluids such as sputum smears, bronchial brushings, bronchial washings, prostate secretions, breast secretions, gastric fluid, spinal fluid, peritoneal fluid, pleural fluid, urinary sediment, cervical smears, and vaginal smears, or from paraffin block specimens of concentrated spinal, pleural, or peritoneal fluid. In cancer registry terminology, FNA does not qualify as ‘cytology’ and is classified as a biopsy under Code 1.
This coding rule differs from the Surgical Diagnostic and Staging Procedure data item, which is not a required field for FCDS. Please review the STORE manual for clarification on how to code the Surgical Diagnostic and Staging Procedure.
Visit the FCDS website to download the Data Acquisition Manual, which includes General Abstracting Instructions for coding diagnostic confirmation.
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