L4E rule 4 (2018) - Revision history

Michael at 01:12, 20 May 2019

2019-05-20T01:12:59Z

← Older revision		Revision as of 01:12, 20 May 2019
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	==See also==		==See also==
	*[[L4E rules of 2014]].		*[[L4E rules of 2018]].
			*[[L4E rule 4 (2014)]].

	==References==		==References==

Michael: /* Details */

2019-05-20T01:12:24Z

Details

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 |}
 Note:
 *[[L4E rule 5 (2014)|Rule 5]] may apply to cases requiring a synoptic report as per the CAP.
 ==See also==

Michael: /* History */

2019-05-20T01:11:56Z

History

← Older revision		Revision as of 01:11, 20 May 2019
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	==History==		==History==
	*The CAP-ACP workload committee document states this rule has ''not'' been modified from the 2014 edition of L4E (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in the 2018 edition of L4E results in a different weighting where larger cases have significantly less value.		*The CAP-ACP workload committee document states this rule has ''not'' been modified from the 2014 edition of L4E (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in the 2018 edition of L4E results in a different weighting where larger cases have significantly less value.
	**A 10 block benign hemithyroidectomy in 2014 was 3.33 L4Es; in the 2018 edition ~~this would be~~ 2.5 L4Es.		**A 10 block benign hemithyroidectomy in 2014 was 3.33 L4Es; in the 2018 edition it is 2.5 L4Es.

	==Details==		==Details==

Michael: /* History */

2019-05-19T23:51:49Z

History

← Older revision		Revision as of 23:51, 19 May 2019
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	==History==		==History==
	*The CAP-ACP workload committee document states this rule has ''not'' been modified from the 2014 edition of L4E (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in 2018 edition results in a different weighting where larger cases have significantly less value.		*The CAP-ACP workload committee document states this rule has ''not'' been modified from the 2014 edition of L4E (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in the 2018 edition of L4E results in a different weighting where larger cases have significantly less value.
			**A 10 block benign hemithyroidectomy in 2014 was 3.33 L4Es; in the 2018 edition this would be 2.5 L4Es.

	==Details==		==Details==

Michael: /* Overview */

2019-05-19T23:49:36Z

Overview

← Older revision		Revision as of 23:49, 19 May 2019
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	*This rule applies to most benign resections.		*This rule applies to most benign resections.
	*It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.		*It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.
	*The CAP-ACP workload committee document states this rule has ''not'' been modified (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in 2018 edition results in a different weighting where larger cases have significantly less value.
			==History==
			*The CAP-ACP workload committee document states this rule has ''not'' been modified from the 2014 edition of L4E (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in 2018 edition results in a different weighting where larger cases have significantly less value.

	==Details==		==Details==
	{\| class="wikitable sortable"		{\| class="wikitable sortable"

Michael at 23:47, 19 May 2019

2019-05-19T23:47:55Z

← Older revision		Revision as of 23:47, 19 May 2019
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	*This rule applies to most benign resections.		*This rule applies to most benign resections.
	*It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.		*It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.
	*The CAP-ACP workload committee ~~references~~ states this rule has ''not'' been modified (see ''Page 4''). However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E); thus, the rule ~~on a practical level~~ results a different weighting where larger cases have significantly less value.		*The CAP-ACP workload committee document states this rule has ''not'' been modified (see ''Page 4'').<ref name=capacp2018/> However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E);<ref name=capacp2018/> thus, the rule in 2018 edition results in a different weighting where larger cases have significantly less value.
	==Details==		==Details==
	{\| class="wikitable sortable"		{\| class="wikitable sortable"

Michael: tweak

2019-05-19T23:46:16Z

tweak

New page

This article covers '''L4E rule 4''' for the 2018 [[L4E]] [[workload]] system. An overview of the L4E rules is found in the [[L4E rules of 2018]].

The definitive reference for the rule is found on the CAP-ACP website.<ref name=capacp2018>Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2018. URL: [https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP_Workload_Model_2018_Final_2020180907(1).pdf https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP_Workload_Model_2018_Final_2020180907(1).pdf]. Accessed on: 19 May 2019.</ref>

You can test your knowledge in the ''[[Quiz:L4E rule 4 (2018)|L4E rule 4 quiz]]''.

==Overview==
*This rule applies to most benign resections.
*It applies to some small biopsies that are submitted in several blocks, e.g. an endoscopically resected large tubular adenoma of the colon without high-grade dysplasia submitted in 3 blocks.
*The CAP-ACP workload committee references states this rule has ''not'' been modified (see ''Page 4''). However, the ''General Guidelines for Coding'' (see ''Page 7'') have changed for L2 (from 0.333 L4E to 0.25 L4E); thus, the rule on a practical level results a different weighting where larger cases have significantly less value.
==Details==
{| class="wikitable sortable"
! Specimen type(s)
! Weight (L4E)
! Details
! Examples
|-
| Most non-malignant resections (see below)
| 1 L2/block, 0.25 L4E/block, minimum 1 L3 (0.5 L4E)
| 1 block = 0.5 L4E, 2 blocks = 0.5 L4E, 3 blocks = 0.75 L4E, 4 blocks = 1 L4E, 5 blocks = 1.25 L4E
| benign hysterectomy in 12 blocks = 3 L4E, hemithyroid with nodular hyperplasia in 16 blocks = 4 L4E
|}
Note:
*[[L4E rule 5 (2014)|Rule 5]] may apply to cases requiring a synoptic report as per the CAP.

===Specimens this rule applies to===
Benign disease in:
*Hysterectomy.
*Thyroidectomy.
*Simple Nephrectomy.
*Breast lumpectomy.
*Small bowel resection.
*Large bowel resection.
*Sleeve gastrectomy.
*Appendix.

Malignant disease - non-radical resections:
*Partial nephrectomy.
*Hemithyroidectomy with cancer.

==See also==
*[[L4E rules of 2014]].

==References==
{{Reflist|1}}

[[Category:Workload]]