American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Facility Oncology Registry Data Standards (FORDS): Revised for 2015


The Commission on Cancer (CoC) is pleased to provide this complimentary copy of FORDS: Revised for 2015 for your individual use. Please understand, however, that this information is the copyrighted property of the Commission on Cancer of the American College of Surgeons. Any use of this material outside of its original format or context requires permission from the CoC. You may print a copy for your own use.

FORDS: Revised for 2015

This version of FORDS replaces all previous versions.  Registries are encouraged to read the Preface and review Appendix C for an overview of 2015 changes.  No new data items have been added.  However, several changes in coding rules and coding categories are incorporated.

  • Required Staging.  Both clinical and pathologic AJCC T, N, M and Stage Group as well as Collaborative Staging are required for Class of Case 10-22.
  • Rules for Coding Grade/Differentiation.  New rules for coding Grade/Differentiation were implemented by all U.S. cancer registry standard setters beginning with cases diagnosed in 2014, and were widely published at that time.  However, no FORDS update was produced for 2014.  The new rules are included in FORDS: Revised for 2015.
  • Clarification for Coding Biopsies Followed by Surgery.  If a needle biopsy preceded an excisional biopsy or more extensive surgery, even if no tumor remained at the time of surgery, both the needle biopsy (Surgical Diagnostic and Staging Procedure) and the Surgical Procedure of the Primary Site are to be reported.
  • Clarification for Reporting Dose for Photon Treatment.  For photon treatment, dosage is reported in cGe units (Cobalt Gray Equivalent) rather than cGy. Record 100x cGe for Regional Dose: cGy (note that it is necessary to multiply cGe by 100 to code this).
  • New Sex Codes.  New codes 5 (Transsexual, natal male) and 6 (Transsexual, natal female) were introduced for use in 2015, and may be used for historic cases if desired. Code 4 (formerly “Transsexual”) is now “Transsexual, NOS”.
  • New Code for RX Date-Other Flag.  Code 15 was added to be used when treatment coded as Other Therapy was planned, but had not been administered yet at the time of last follow-up. Code 15 may be assigned for cases diagnosed prior to 2015, if applicable.
  • Discontinued Items.  Grade Path System and Grade Path Value are required for cases diagnosed from 2010 through 2013, but are discontinued under the Grade/Differentiation coding rules.  The ICD Revision Secondary Diagnosis is no longer required for any diagnosis year because the separate fields for ICD-9-CM and ICD-10-CM eliminate the need for the item.

All items in FORDS are required for CoC-accredited cancer programs. Supplementary references are necessary for coding American Joint Committee on Cancer, collaborative stage, multiple primaries and histologies, hematopoietic tumors, and systemic agents.

Complete Manual

FORDS: Revised for 2015

Changes introduced since January 1, 2011, are described in Appendix C.

Change in Coding "Scope Regional Lymph Node Surgery"

Problems with the coding directives for the item "Scope Regional Lymph Node Surgery" were identified in April 2011. This document provides background describing the origin and scope of the problem, how each agency plans to address the issue moving forward, and the changes in coding instructions for items RX  Hosp--Scope Reg LN Sur (NAACCR Item # 672) and RX Summ--Scope Reg LN Sur (NAACCR Item # 1292).

New instructions and clarifications to guide the coding for this data element for implementation for cases diagnosed January 1, 2012, and later are included in this document.

Earlier versions of CoC registry coding manuals are available online.