Tumor Tips

Tumor Tip of the Week-12-13-2024 Radiation Treatment Volume

Scenario:

  • 2/23/24 Spinal CT with expansile lesion in the sacrum measuring 5.0 cm with innumerable lytic lesions throughout the skeleton concerning for myeloma
  • 2/29/24 Sacral lesion bx confirm plasmacytoma
  • Due to pain and lesion size they decide to do radiation
  • 3/8/24-3/21/24 Photon Rapid Arc therapy to the sacrum, 3000 cgy in 10 fractions

Question: How would I assign Phase I-II-III Radiation Primary Treatment Volume?

  • 81 Spine/vertebral bodies
  • 85 Pelvic Bones

Answer: 81 Spine/vertebral bodies

Rationale:

STORE Phase I-II-III Radiation Primary Treatment Volume. 

Don’t get caught up in using just the drop-down menu in your registry software.  If you review the actual definitions in the STORE manual for this field.   You will also see the definition for code 81 includes the sacrum and the instructions explicitly state not to use code 85 if the treatment volume is sacrum.  There are lots of helpful hints for how to code these fields in the STORE Manual.  Be sure to read the actual definitions for the field and don’t forget to also utilize APPENDIX R: CTR Guide to Coding Radiation Therapy Treatment in the STORE for examples of how to code a wide variety of scenarios.

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