L4E rule 9 (2014)
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The definitive reference for this rule in found on the CAP-ACP website.
- This rule applies to radical resections and complex cases.
- It defines the L6 code as an all encompassing code for a case. Resections that include lymph nodes and several organs are given a L6 code and adjusted upwards if (1) >30 blocks (see details) and/or (2) require more than one CAP synoptic report.
|Specimen (s)||Weight (L4E)||Details||Examples|
|Radical resections with one synoptic||10 L4E + 0.33 L4E/block for each block >30 blocks||30 blocks = 10 L4E, 31 blocks = 10.33 L4E, 32 blocks = 10.66 L4E||prostatectomy with lymph nodes in 30 blocks = 10 L4E, radical mastectomy with lymph nodes in 60 blocks = 10 L4E + 30 x 0.33 L4E = 60 L4E|
|Radical resections with more than one synoptic||10 L4E + 0.33 L4E/block for each block >30 blocks + 5 L4E/additional synoptic||30 blocks = 10 L4E, 31 blocks = 10.33 L4E, 32 blocks = 10.66 L4E||cytoprostatecomy with lymph nodes UCC and Pca in 45 blocks = 10+5+5 L4E, radical bilateral mastectomy with lymph nodes and 2 separate cancers in 66 blocks = 10+12+5 L4E|
- 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.