Training Issues

Obviously there will have to be some re-training of coders before ICD-O-3 is implemented, because some current coding rules will be altered.

There is a graying distinction between benign and malignant words. Pathologists think of "grade" as a synonym for "type" and as a result, terminology that registrars might think of using to code the 6th digit may change.

Renal cell is coming to be an "umbrella" term like duct cell. This will affect our 'code to the highest code' rule.

The terms "adult" and "mature" describe the cell, not the age of the patient.

"Transitional" has two meanings--it could be a cell type, or it could be a neoplasm that is converting to something else.

ICD-O-3 has adopted the European standard of writing eponyms--no apostrophe 's'. Therefore, it will be "Klatskin tumor" (instead of Klatskin's tumor) and "non-Hodgkin lymphoma" (instead of non-Hodgkin's lymphoma). As previously mentioned, there will be a lot more acronyms: ECL (enterochromaffin-like), MPNST, CPNET, DCIS, PIN, VIN, etc.

We also have to reinforce the matrix concept--the present rule that says it is OK to change the behavior code of a published diagnosis so that it truly reflects what the pathologist describes as the behavior.

Some terms are no longer obviously benign or malignant.