Tumor Tip of the Week-09-28-2023 Clearing up Confusion on LVI -Thyroid and Adrenal vs All Other Primaries - Omega Healthcare
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Tumor Tip of the Week-09-28-2023 Clearing up Confusion on LVI -Thyroid and Adrenal vs All Other Primaries

  • Omega Healthcare

  • PUBLISHED ON September 29, 2023

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Scenario #1

Colon Resection:

  • Lymphovascular Invasion: Large vessel (venous), extramural
 Scenario#2

Thyroidectomy:

  • Angioinvasion (Vascular Invasion): Present
  • Lymphatic Invasion: Not Identified
Question: How will you Code LVI?

  • 1 Lymphovascular Invasion Present/Identified (NOT used for thyroid and adrenal)

 

  • 2 Lymphatic and small vessel invasion only (L)

OR

Lymphatic invasion only (thyroid and adrenal only)

 

  • 3 Venous (large vessel) invasion only (V)

OR

Angioinvasion (thyroid and adrenal only)

 

  • 4 BOTH lymphatic and small vessel AND venous (large vessel) invasion

OR

BOTH lymphatic AND angioinvasion (thyroid and adrenal only)

 Question: How will you Code LVI?

  • 1 Lymphovascular Invasion Present/Identified (NOT used for thyroid and adrenal)

 

  • 2 Lymphatic and small vessel invasion only (L)

OR

Lymphatic invasion only (thyroid and adrenal only)

 

  • 3 Venous (large vessel) invasion only (V)

OR

Angioinvasion (thyroid and adrenal only)

 

  • 4 BOTH lymphatic and small vessel AND venous (large vessel) invasion

OR

BOTH lymphatic AND angioinvasion (thyroid and adrenal only)
Answer: 3 Venous (large vessel) invasion only (V)

 

 Answer: 3 Angioinvasion (thyroid and adrenal only)

Discussion:  We have noticed some confusion lately, some have the notion that the codes 2,3,4 are only to be used for Thyroid & Adrenal Cases.

This just isn’t the case.   It may look confusing in the drop-down menu of your software, but the actual manual makes it a little bit easier to see the differences.

  • Code 1 is never used for Thyroid & Adrenal Cases.
  • Code 2-4 can be used for any case, but these codes have different meanings for Thyroid & Adrenal Cases.
    • For Example:
      • Code 3 means Venous (large vessel) invasion only (V) for all cases except Thyroid & Adrenal cases.
      • Code 3 means Angioinvasion for Thyroid and Adrenal Cases.
  • Omega Healthcare

  • PUBLISHED ON September, 29 2023

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