This is one of the #1 miscoded fields we audit, despite there being very clear directions in the STORE. Please read the STORE Manual and refer to the instructions on how to code Lymphovascular Invasion(LVI). Below are the most common scenarios coded incorrectly.
Concept | 2022 Scenario | Code LVI per STORE |
Ambiguous Terms | Lung Resection for Invasive Squamous Cell Carcinoma, path report states Lymphovascular invasion: Foci suspicious for lymphatic invasion identified | 9 Unknown/Indeterminate/not mentioned in path report CAnswer Forum Post-Do not use ambiguous terms for LVI http://cancerbulletin.facs.org/forums/forum/fords-national-cancer-data-base/store/other-general-questions/106340-lymphovascular-invasion-suspicious |
Benign/Borderline Brain & CNS or GIST | Resection of Benign Brain Tumor, LVI not mentioned on Path Report OR Resection of Gastrointestinal Stromal Tumor-LVI not mentioned on Path Report | 8 Code 8, Not Applicable for benign/borderline brain and CNS tumors and Gastrointestinal Stromal Tumors (GIST). |
In Situ | Polypectomy +Adenocarcinoma in Situ, LVI not mentioned on path report | 0 Use code 0 when the pathology report indicates that there is no lymphovascular invasion. This includes cases of purely in situ carcinoma, which biologically have no access to lymphatic or vascular channels below the basement membrane. |
Neoadjuvant Therapy | Colonoscopy+ Rectal Adenocarcinoma {LVI not mentioned on path report} Patient treated with neoadjuvant XRT/Chemo Ater neoadjuvant treatment patient undergoes resection path report states LVI Not Identified | 9 For cases treated with neoadjuvant therapy, refer to table below in order to code this field |
Small Vessel Invasion | Colon Resection Lymphovascular Invasion: Identified Small Vessel Invasion | 2 Lymphatic and small vessel invasion only (L) |
Thyroid Dx 2022+ Angioinvasion &LVI | Thyroidectomy Angioinvasion (Vascular Invasion): Present Lymphatic Invasion: Present | 4 BOTH lymphatic AND angioinvasion (thyroid and adrenal only) |
Thyroid Dx 2022+ No Angio +LVI | Thyroidectomy Angioinvasion (Vascular Invasion): Not Identified Lymphatic Invasion: Present | 2 Lymphatic invasion only (thyroid and adrenal only) |
Thyroid Dx 2022+ Angioinvasion+/LVI (-) | Thyroidectomy Angioinvasion (Vascular Invasion): Present Lymphatic Invasion: Not Identified | 3 Angioinvasion (thyroid and adrenal gland) |
TURBT | TURBT: Invasive Low Grade Papillary Urothelial Carcinoma. LVI was not mentioned on the path report. | 9 not mentioned in path report |