NAACCR Surgery Code Crosswalks Enable Analysis Over Time

Submitted on behalf of the NAACCR Surgery Code Crosswalk Task Force

Background

If you are familiar with cancer registry operations, you are probably aware that surgery codes have undergone significant changes for 2023 and 2024. A new data item, RX Summ–Surg Prim Site 2023 [1291], was introduced in 2023. The new data item is used to collect information on surgery to the primary site for cases diagnosed in 2023 and later. We will continue to use the data item RX Summ–Surg Prim Site 03-2022 [1290] to collect information on surgery to the primary site for cases diagnosed prior to 2023.

The codes for the new data item have been expanded to 4 characters (old codes are 2 characters) and are alphanumeric (old codes are numeric). The new format allows greater flexibility when adding new surgical procedures and grouping similar procedures together. The alpha character at the beginning of each code represents versioning. If a meaningful change occurs to the codes for a specific site, the versioning will change incrementally.

Below is an example of how the surgery codes for a simple mastectomy have changed.

In the example shown above, the “A” in the code A400 indicates the code definition did not change from the code definitions used for breast cases in the data item RX Summ–Surg Prim Site 03-2022 [1290]. The “A” was added to the beginning of the new code for versioning purposes.
A major update to the breast surgery codes was implemented for cases diagnosed in 2024 and later. The change is indicated by the “B” in the surgery code for cases diagnosed in 2024. The code for simple mastectomy also changed from 400 to 600.

Crosswalk

Changes to the surgery of primary site data item were made to make it easier to add new surgical procedures, remove outdated surgical procedures, show that changes had been made, and better group similar surgical procedures. However, the move to a new data item and changes to the codes and code definitions present challenges to anyone interested in looking at surgery codes over time. When analyzing surgery of primary site coding over time, two different data items with codes in different formats must be reviewed. Additionally, significant changes to codes and code definitions have been made to 6 sites since the implementation of RX Summ–Surg Prim Site 2023 [1291].

The skin surgery codes were updated for cases diagnosed in 2023 and later. Breast, lung, colon, thyroid, and pancreas were updated for cases diagnosed in 2024 and later. The updated surgery codes begin with a B.

In an effort to assist those interested in analyzing surgery codes over time, crosswalks have been developed for the sites with updated codes. The crosswalks are intended to be used by analysts, quality control evaluators, cancer registry software vendors, and registrars in hospitals interested in looking at surgery data over time. These crosswalks are not intended to be used by registrars abstracting cancer cases.

Each crosswalk translates surgery codes from one diagnosis year to another. The translation is one way. For example, the crosswalk for breast includes the following translations:

2023 to 2003-2022 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2003-2022 [1290] data item -Translates from 2023 (A Codes) to 2003-2022 (2-Digit Codes)

2024 to 2003-2022 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2003-2022 [1290] data item – Translates from 2024 (B Codes) to 2003-2022 (2-Digit Codes)

2003-2022 to 2023 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2023 [1291] data item – Translates from 2003-2022 (2-Digit Codes) to 2023 (A Codes)

2024 to 2023 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2023 [1291] data item – Translates from 2024 (B Codes) to 2023 (A Codes)

2003-2022 to 2024 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2023 [1291] data item – Translates from 2003-2022 (2-Digit Codes) to 2024 (B Codes)

2023 to 2024 – Use this crosswalk when the result wanted is for the RX Summ–Surg Prim Site 2023 [1291] data item – Translates from 2023 (A Codes) to 2024 (B Codes)

Surgery Codes

In addition to the crosswalks, copies of surgery codes by diagnosis year have been posted to the NAACCR Crosswalks page . These are the codes as they appear in STORE  and the SEER Program Coding and Staging Manual for specific diagnosis years. The lists are meant to be used as a quick reference for anyone reviewing surgery codes over time.

Surgery Code Crosswalk Taskforce

The crosswalks were developed through the hard work of the Surgery Code Crosswalk Taskforce. Taskforce members are listed below.