Cholangiocarcinoma miscoding in hepatobiliary centres

Introduction Cholangiocarcinoma (CCA) are sub-divided into intrahepatic (iCCA) or extrahepatic (eCCA). eCCA further subdivided perihilar (pCCA) and distal (dCCA). Current previous versions of the WHO International Coding Disease Oncology classifications (ICD) have separate topography codes for iCCA eCCA, but none pCCA. Over recent decades, multiple studies report rising incidence rates with declining without reference to We hypothesised lack a specific code pCCA has led errors CCA coding, specifically miscoding as iCCA. Methods Clinical notes cases coded hepatobiliary carcinoma using ICD-10 criteria (C22.1/Intrahepatic Bile Duct carcinoma, C24.0/Extrahepatic C23X/Malignant Neoplasm Gall Bladder, C22.0/Malignant Liver Cell Carcinoma) over 2 year period (2015–2017), were reviewed by two independent clinicians at three UK regional HepatoPancreatoBiliary centres. The agreed final diagnosis was compared originally allocated code. Results Of 625 fully reviewed, 226 C22.1/iCCA. 98 (43%) these true correctly, while 76 (34%) actually 92% all incorrectly Conclusion coding misclassification in HPB centres is common, particularly pCCA, which commonest form CCA, This may be contributing apparent Our findings confirm need implement distinct topographical iCCA, dCCA future iterations ICD.