L4E rule 1-3 (2014)

This article covers L4E rule 1-3 for the 2014 L4E workload system.

An overview of the L4E rules is found in the L4E rules of 2014.

Context

Specimen type(s)	Weight (L4E)	Details	Examples	Rule
Complex skin biopsies/non-GI biopsies with countable fragments	1 L4E / 5 tissue fragments (frags), all fractions are rounded down	1-5 frags = 1 L4E, 6-10 frags = 2 L4E, 11-15 frags = 3 L4E, 16-20 frags = 4 L4E "complex skin" includes inflammatory skin, malignancies except BCC and SCC, atypical melanocytic lesions, adnexal tumours, lymphoid infiltrates	inflammatory skin biopsy 3 frags = 1 L4E, adnexal skin tumour 6 frags = 2 L4E	Rule 1 ^[1]
Simple skin (non-complex skin)	1 L3/biopsy, 0.5 L4E/biopsy	biopsies > 2 cm - use L4E rule 4	punch biopsy of BCC = 0.5 L4E, shave biopsy of seborrheic keratosis = 0.5 L4E	Rule 1 ^[1]
Breast core biopsies & prostate core biopsies	1 L3 per core (0.5 L4E/core)	maximum of 20 cores, should use clinicians core count (if available) - if clinicians' count not available use gross count	4 breast cores = 2 L4E 12 prostate cores = 6 L4E	Rule 2 ^[1]
Core biopsies (not including prostate, breast)	1 L4E / 5 cores, all fractions are rounded down	1-5 cores = 1 L4E, 6-10 cores = 2 L4E, 11-15 cores = 3 L4E, 16-20 cores = 4 L4E	3 cores of lymph node = 1 L4E, 6 cores of mediastinal mass = 2 L4E	Rule 2 ^[1]
Fragmented tissue/curettage	1 L4E / 3 blocks, all fractions are rounded down	1-3 blocks = 1 L4E, 4-6 blocks = 2 L4E, 7-9 blocks = 3 L4E, 10-12 blocks = 4 L4E, 13-15 blocks = 4 L4E	endometrial biopsy in 2 blocks = 1 L4E, TURP in 7 blocks = 3 L4E, bladder biopsy in 12 blocks = 4 L4E	Rule 3 ^[1]

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Workload and Workforce Committee of the CAP-ACP. Workload Measurement Guidelines. Canadian Association of Pathologists (CAP-ACP). 2014. URL: https://www.cap-acp.org/cmsUploads/CAP/File/CAP-ACP%202014%20Workload%20FINAL.pdf. Accessed on: 17 October 2017.