Division Chief: Christopher Shaari, MD
Quality Indicators
(Medical/Surgical/Radiation):
- PET/CT completed 3 months after treatment.
- Swallowing function evaluated post-op.
- Complete ultrasound needle biopsy of neck node or thyroid nodule within 10 days of initial contact.
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:
Ethmoid Sinus Tumors, Squamous cell carcinoma, Undifferentiated carcinoma, Adenocarcinoma, Salivary gland tumor, Esthesioneuroblastomas, Sarcoma (non-rhabdomyosarcoma)
| ICD 9 Codes |
| 160.3 |
| 160.4 |
| 160.5 |
| 160.8 |
| 160.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 231.8 |
| 235.9 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History & Physical Examination
|
|
CBC
|
|
Chemistry
|
|
Chest x-ray
|
|
CT or MRI of base of skull to clavicle with contrast
|
|
PET/CT Scan
|
|
Pathology review for an incomplete excision
|
|
|
Cancer of the Hypopharynx, Pyriform sinus, Lateral and posterior pharyngeal walls, Postcricoid area
| ICD 9 Codes |
| 148.0 |
| 148.1 |
| 148.2 |
| 148.3 |
| 148.8 |
| 148.9 |
| 149.0 |
| 149.1 |
| 149.8 |
| 149.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 209.25 |
| 230.0 |
| 235.1 |
| 235.9 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Preanesthesia studies
|
|
Examination under anesthesia with laryngoscopy and esophagoscopy
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT chest with contrast
|
|
CT or MRI of primary and neck with contrast
|
|
MRI of primary and neck with and without gadolinium
|
|
PET/CT Scan
|
|
Dental evaluation
|
|
Multidisciplinary consultation
|
|
| Prognostic Work Up |
|
Stage
|
|
Distant dissemination
|
|
Persistent or recurrent locoregional disease
|
| |
|
Cancer of the Larynx, Supraglottis, Glottis, Subglottis
| ICD 9 Codes |
| 161.0 |
| 161.1 |
| 161.2 |
| 161.3 |
| 161.8 |
| 161.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 231.0 |
| 235.6 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Preanesthesia studies
|
|
Examination under anesthesia with laryngoscopy
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT chest with contrast
|
|
CT with contrast and thin cuts through larynx
|
|
MRI of primary and neck with and without gadolinium
|
|
PET/CT Scan
|
|
Dental evaluation
|
|
Speech & swallowing evaluation
|
|
| Prognostic Work Up |
|
Stage
|
|
Subsites
|
|
Nodal involvement
|
| |
|
Cancer of the Lip
| ICD 9 Codes |
| 140.0 |
| 140.1 |
| 140.3 |
| 140.4 |
| 140.5 |
| 140.6 |
| 140.8 |
| 140.9 |
| 149.0 |
| 149.1 |
| 149.8 |
| 149.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 230.0 |
| 235.1 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Preanesthesia studies
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT or MRI of base of skull to clavicle with contrast
|
|
PET/CT Scan
|
|
Panorex
|
|
Dental evaluation
|
|
| Prognostic Work Up |
|
Lymph node metastases related to location, size, & grade of primary tumor
|
|
Stage
|
|
Maxillary Sinus Tumors
| ICD 9 Codes |
| 160.2 |
| 160.4 |
| 160.5 |
| 160.8 |
| 160.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 231.8 |
| 235.9 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Examination
|
|
CBC
|
|
Chemistry
|
|
CT or MRI head & neck with contrast
|
|
PET/CT Scan
|
|
Chest X-Ray
|
|
Dental/prosthetic consultation
|
|
| Prognostic Work Up |
|
Tumor stage
|
|
Tumor histology
|
|
Cancer of the Nasopharynx
| ICD 9 Codes |
| 147.0 |
| 147.1 |
| 147.2 |
| 147.3 |
| 147.8 |
|
147.9
|
| 149.0 |
| 149.1 |
| 149.8 |
| 149.9 |
| 160.0 |
| 160.8 |
| 160.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 209.25 |
| 230.0 |
| 235.1 |
| 235.9 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Nasopharyngeal exam
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT chest with contrast
|
|
CT or MRI of nasopharynx and base of skull to clavicles with contrast
|
|
CT abdomen & pelvis with contrast to evaluate for metastases
|
|
PET/CT Scan to evaluate for metastases
|
|
Dental evaluation
|
|
| Prognostic Work Up |
|
Stage
|
|
Histology (controversial)
|
|
Cancer of the Oral Cavity, Buccal mucosa, Upper and lower alveolar ridge, Retromolar trigone, Floor of the mouth, Hard Palate, Anterior two thirds of the tongue
| ICD 9 Codes |
| 141.1 |
| 141.2 |
| 141.3 |
| 141.4 |
| 141.5 |
| 141.6 |
| 141.8 |
| 141.9 |
| 143.0 |
| 143.1 |
| 143.8 |
| 143.9 |
| 144.0 |
| 144.1 |
| 144.8 |
| 144.9 |
| 145.0 |
| 145.1 |
| 145.2 |
| 145.3 |
| 145.4 |
| 145.5 |
| 145.6 |
| 145.8 |
| 145.9 |
| 149.0 |
| 149.1 |
| 149.8 |
| 149.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 230.0 |
| 235.1 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Preanesthesia studies
|
|
Examination under anesthesia
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT chest with contrast
|
|
Panorex
|
|
MRI of skull base to clavicle with and without gadolinium
|
|
PET/CT Scan
|
|
Dental evaluation
|
|
Multidisciplinary consultation
|
|
| Prognostic Work Up |
|
Stage
|
|
Subsite
|
|
Cancer of the Oropharynx, Base of tongue, Tonsils, Soft palate, Posterior pharyngeal wall
| ICD 9 Codes |
| 146.0 |
| 146.1 |
| 146.2 |
| 146.3 |
| 146.4 |
| 146.5 |
| 146.6 |
| 146.7 |
| 146.8 |
| 146.9 |
| 141.0 |
| 149.0 |
| 141.8 |
| 145.3 |
| 149.0 |
| 149.1 |
| 149.8 |
| 149.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 209.25 |
| 230.0 |
| 235.1 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Preanesthesia studies
|
|
Examination under anesthesia with laryngoscopy
|
|
Biopsy
|
|
Pathology and cytology review
|
|
Chest x-ray
|
|
CT or MRI of primary, neck and chest with contrast
|
|
PET/CT Scan
|
|
Panorex
|
|
Dental evaluation
|
|
Speech & swallowing evaluation
|
|
Multidisciplinary consultation
|
|
| Prognostic Work Up |
|
Subsite involved
|
|
Stage
|
|
Salivory Gland Tumors, Parotid, Submaxillary, Sublingual salivary gland, Minor salivary gland
| ICD 9 Codes |
| 142.0 |
| 142.1 |
| 142.2 |
| 142.8 |
| 145.9 |
| 194.1 |
| 194.5 |
| 195.0 |
| 230.0 |
| 235.0 |
| 235.1 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Examination
|
|
CBC
|
|
Chemistry
|
|
CT or MRI of base of skull to clavicle with contrast
|
|
Chest x-ray
|
|
PET/CT Scan
|
|
Fine needle aspiration or open biopsy
|
|
Pathology and cytology review
|
|
| Prognostic Work Up |
|
Histologic grade
|
|
Tumor size
|
|
Local Invasion
|
|
Stage
|
|
Thyroid Cancer
| ICD 9 Codes |
| 193.0 |
| 194.1 |
| 194.5 |
| 195.0 |
| 234.9 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Thyroid Function Tests
|
|
Thyroid ultrasound
|
|
MRI of neck with and without gadolinium
|
|
Chest x-ray
|
|
PET/CT Scan
|
|
Endocrinology consultation
|
|
Ultrasound guided biopsy
|
|
Pathology and cytology review
|
|
| Prognostic Work Up |
|
Age
|
|
Metastases
|
|
Increasing size
|
|
Extracapsular spread
|
|
Unknown Primary
| ICD 9 Codes |
| 209.20 |
| 234.8 |
| 239.8 |
| 239.9 |
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
Chest x-ray
|
|
CT or MRI of neck with contrast
|
|
PET/CT Scan
|
|
Ultrasound guided biopsy
|
|
Pathology and cytology review
|
|
| Prognostic Work Up |
|
Multiple Sites of tumor
|
|
Bone disease
|
|
Malignant Neoplasm of the Auditory Tube, Middle Ear, & Mastoid Cells
|
|
| Diagnostic Work Up |
| Test/Exam: |
|
History and Physical Exam
|
|
CBC
|
|
Chemistry
|
|
CT or MRI of temporal bone with and without contrast
|
|
|
