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Difference between revisions of "L4E rule 1-3 (2018)"
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==History== | ==History== | ||
*''Rule 1'' and ''Rule 3'' are unchanged from ''[[Level 4 equivalent of 2014]]''. | *''Rule 1'' and ''Rule 3'' are unchanged from ''[[Level 4 equivalent of 2014]]''. | ||
*''Rule 2'' was changed to lower the value of | *''Rule 2'' was changed to lower the value of prostate core biopsies sets with a large number of cores; compare with ''[[L4E rule 1-3 (2014)]]''. | ||
==Details== | ==Details== | ||
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| Simple skin (non-complex skin) | | Simple skin (non-complex skin) | ||
| 0.5 L4E/biopsy (1 L3/biopsy) | | 0.5 L4E/biopsy (1 L3/biopsy) | ||
| biopsies > 2 cm - use [[L4E rule 4 ( | | biopsies > 2 cm - use [[L4E rule 4 (2018)|L4E rule 4]]; includes [[basal cell carcinoma|BCC]], SCC, actinic keratosis, intradermal nevus | ||
| punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E | | punch biopsy of BCC = 0.5 L4E, shave biopsy of [[seborrheic keratosis]] = 0.5 L4E | ||
| Rule 1 <ref name=capacp2018/> | | Rule 1 <ref name=capacp2018/> | ||
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| Surgical GI biopsies (neoplastic/pre-neoplastic) | | Surgical GI biopsies (neoplastic/pre-neoplastic) | ||
| 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E | | 1 L3/lesion (if submitted in one block) and low grade; lesion with high-grade dysplasia = 1 L4E | ||
| lesions submitted in >1 block: use [[L4E rule 4 ( | | lesions submitted in >1 block: use [[L4E rule 4 (2018)|L4E rule 4]] | ||
| 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E | | 2 HP polyps in one block = 1 L4E, 1 tubular adenoma negative for HG dysplasia = 0.5 L4E | ||
| Rule 1 <ref name=capacp2018/> | | Rule 1 <ref name=capacp2018/> | ||
|- | |- | ||
| Breast core biopsies & prostate core biopsies | | Breast core biopsies & prostate core biopsies | ||
| 1 L4E for 1st core + 0.25 L4E | | 1 L4E for 1st core + 0.25 L4E for each additional core + 3 L4E for synoptic (if mandated - see [[L4E rule 5 (2018)|L4E rule 5]]) | ||
| | | should use clinicians core count (if available), if clinicians' count not available use gross count | ||
| 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E | | 4 breast cores = 1.75 L4E<br>12 prostate cores (without synoptic report) = 3.75 L4E<br>12 prostate cores (with synoptic report) = 6.75 L4E | ||
| Rule 2 <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> | | Rule 2 <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> | ||
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{{hide3|9. Random colonic biopsies 20 frags. L4E?|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}} | {{hide3|9. Random colonic biopsies 20 frags. L4E?|Answer: 3 L4E<br>Why? Rule 1: 20 frags x L3/3 frags ~ 6.66 L3 -> truncated to 6 L3, 6 L3 ~ 3 L4E}} | ||
{{hide3|10. Prostate biopsy with 12 cores. L4E?|Answer: | {{hide3|10. Prostate biopsy with 12 cores without synoptic report. L4E?|Answer: 3.75 L4E<br>Why? Rule 2: 1 L4E (first core) + 11 cores x 0.25 L4E/core ~ 3.75 L4E}} | ||
{{hide3|11. Breast biopsy with 2 cores. L4E?|Answer: 1 L4E<br>Why? Rule 2: | {{hide3|11. Breast biopsy with 2 cores. L4E?|Answer: 1.25 L4E<br>Why? Rule 2: 1 L4E + 0.25 L4E ~ 1.25 L4E}} | ||
{{hide3|12. Endometrial biopsy in 2 blocks. L4E?|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}} | {{hide3|12. Endometrial biopsy in 2 blocks. L4E?|Answer: 1 L4E<br>Why? Rule 3: 1-3 blocks ~ 1 L4E}} | ||
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==See also== | ==See also== | ||
*[[L4E rules of 2018]]. | *[[L4E rules of 2018]]. | ||
*[[L4E rule 1-3 (2014)]]. | |||
==References== | ==References== | ||