Division Co-Chiefs: Ihor Sawczuk, MD, Glen Gejerman, MD, Robert Alter, MD
Quality Indicators
(Medical/Surgical/Radiation):
- Patients diagnosed with renal cell cancer have the following prognostic factors evaluated and dictated in their chart. (Medical)
- LDH level
- Hemoglobin level
- Corrected serum calcium level
- Interval from original diagnosis to the start of systemic therapy
- KPS
- Metastasis
- Pelvic lymph node dissection performed during radical cystectomy. (Surgical)
- TNM staging completed for surgical cases. (Surgical)
- The following tests are performed pre and post radiation therapy in prostate cancer patients. (Radiation)
- PSA level
- IPS score
- Erectile function index
All Patients
- All patients with solid tumors are staged according to ACoS standards.
- All patients who are receiving chemotherapy have a plan documented prior to administration of therapy.
Diagnostic Work Up:
Bladder Cancer
| ICD 9 Codes |
| 188.0 |
| 188.1 |
| 188.2 |
| 188.3 |
| 188.4 |
| 188.5 |
| 188.6 |
| 188.7 |
| 188.8 |
| 188.9 |
| 194.0 |
| 233.7 |
| 233.9 |
| 236.7 |
| 236.90 |
| 236.99 |
| 239.4 |
|
| Diagnostic Work Up |
| Test/Exam: |
| History & Physical Examination |
| CBC |
| Chemistry profile & alkaline phosphatase |
| Creatinine Clearance |
| Office cystoscopy |
| CT Abdomen & Pelvis with contrast |
| Chest x-ray |
| Bone scan if alkaline phosphatase is elevated or symptoms are present |
| Urine Cytology |
|
| Prognostic Work Up |
|
Positive/Negative lymph nodes
|
| Distant metastasis |
|
Kidney Cancer/Renal Cell Cancer
| ICD 9 Codes |
| 189.0 |
| 189.2 |
| 189.3 |
| 189.4 |
| 189.8 |
| 189.9 |
| 194.0 |
| 209.24 |
| 233.9 |
| 236.91 |
| 236.99 |
| 239.5 |
|
| Diagnostic Work Up |
| Test/Exam: |
| History & Physical Examination |
| CBC |
| Chemistry Profile |
| LDH |
| Urinalysis |
| CT Abdomen & Pelvis with contrast |
|
| Prognostic Work Up |
|
Positive/Negative lymph nodes
|
| Elevated liver enzymes |
| Vascular involvement |
| |
|
Renal Pelvis Cancer
| ICD 9 Codes |
| 189.1 |
| 194.0 |
| 233.9 |
| 236.91 |
| 236.99 |
| 239.5 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
CBC
|
|
Chemistry profile
|
|
Chest x-ray
|
|
Bone scan if indicated
|
|
CT urogram
|
|
Cytology
|
|
Cystoscopy
|
|
Retrograde pyelogram
|
|
| Prognostic Work Up |
|
Positive/Negative lymph nodes
|
|
Distant metastasis
|
|
Transitional Cell Carcinoma of the Ureter
| ICD 9 Codes |
| 189.2 |
| 194.0 |
| 233.9 |
| 236.91 |
| 236.99 |
| 239.5 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
CBC
|
|
Chemistry Profile
|
|
IVP
|
|
Cytology
|
|
Cystoscopy
|
|
Retrograde pyelogram
|
|
Chest x-ray
|
|
Bone scan if indicated
|
|
| Prognostic Work Up |
|
Positive/Negative lymph nodes
|
|
Distant metastasis
|
|
Prostate Cancer
| ICD 9 Codes |
| 185.0 |
| 194.0 |
| 233.4 |
| 236.4 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
CBC
|
|
Chemistry Profile
|
|
PSA
|
|
Digital Rectal Examination
|
|
Transrectal ultrasound and core needle biopsy
|
|
Pathology review and gleason score
|
|
Bone Scan if indicated
|
|
CT Pelvis with contrast if indicated
|
|
Possible Endorectal MRI Exam
|
|
| Prognostic Work Up |
|
PSA
|
|
Bone metastasis
|
|
Positive/Negative lymph nodes
|
| |
|
Penile Cancer
| ICD 9 Codes |
| 187.1 |
| 187.2 |
| 187.3 |
| 187.4 |
| 187.5 |
| 187.6 |
| 187.7 |
| 187.8 |
| 187.9 |
| 194.0 |
| 233.5 |
| 236.6 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
CBC
|
|
CT Abdomen & Pelvis with contrast
|
|
Cystoscopy
|
|
Biopsy
|
|
Pathology review
|
|
| Prognostic Work Up |
|
Positive/Negative lymph nodes
|
|
Testicular Cancer, Seminoma, Nonseminomatous germ cell tumor
| ICD 9 Codes |
| 186.0 |
| 186.9 |
| 194.0 |
| 233.6 |
| 236.4 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
Alpha-fetoprotein
|
|
beta-hCG
|
|
Chemistry profile & LDH
|
|
Testicular Ultrasound
|
|
Sperm banking discussion
|
|
| Prognostic Work Up |
|
Tumor markers
|
|
Nodal status
|
|
