. 2009 Apr 15;101(8):571–580. doi: 10.1093/jnci/djp039

Appendix Table.

Codes used to identify processes of care^*

Category	Process of care	Variable specification	ICD-9 diagnosis codes (MEDPAR)	HCPCS codes (National Claims History and Outpatient files)	Descriptor
Surveillance related	Endoscopic surveillance	Discrete variable: use for each 1-month interval for 2 years after diagnosis (range = 0–24 months)	57.32, 57.39	52 000, 52 001, 52 005, 52 007	Cystoscopy: with irrigation and evacuation of blood clots; with ureteral catheter; with brush biopsy of the ureter
			57.33	52 204, 52214	Cystoscopy with biopsy, fulguration
				52 250	Cystoscopy with insertion of radioactive substance, with or without biopsy or fulguration
				52 260, 52 265	Cystoscopy with bladder dilation
			57.91	52 270, 52 275, 52 276, 52 277, 52 281, 52 282, 52 283, 52 285	Cystoscopy with urethral dilation or urethrotomy
				52 290, 52 300, 52 301, 52 305	Cystoscopy with ureteral meatotomy
			57.0	52 310, 52 315	Cystoscopy with removal of foreign body
				52 320, 52 325, 52 327, 52 330, 52 332, 52 334	Cystoscopy for ureteral calculus
				52 317, 52 318	Cystoscopy with lithalopaxy
				52 341, 52 342, 52 343	Cystoscopy for ureteral stricture
			57.92, 60.2	52 347, 52 400, 52 450, 52 500, 52 510, 52 601, 52 606, 52 612, 52 614, 52 620, 52 630, 52 640, 52 647, 52 648, 52 700	Cystoscopy with transurethral prostate surgery
			56.31, 56.33	52 344, 52 345, 52 346, 52 351, 52 352, 52 353, 52 354, 52 355	Cystoscopy with ureteroscopy
				52 224	Cystoscopy, with fulguration or treatment of minor (<0.5 cm) bladder lesions, with or without biopsy
			57.49	52 234, 52 235, 52 240	Cystoscopy, with fulguration and/or resection of small (0.5 up to 2 cm), medium (2 up to 5 cm), large (≥5 cm) bladder tumors
	Upper urinary tract evaluation	Discrete variable: use for each 1-month interval for 2 years after diagnosis (range 0–24)		74 400, 74 410, 74 415	Intravenous urography
				74 420	Retrograde urography
				74 425	Antegrade urography
				74 150, 74 160, 74 170	Abdominal CT
				74 181, 74 182, 74 183, 74 185	Abdominal MRI
	Urinary studies	Discrete variables: use (uniquely for urinalysis and cytology) for each 1-month interval for 2 years after diagnosis (range 0–24)		81 000, 81 001, 81 002, 81 003, 81 005	Urinalysis
	Urinary studies	Dichotomous variable: use of urine cytology at least once during 2-year interval		81 000, 81 001, 81 002, 81 003, 81 005	Urinalysis
				88 104, 88 106, 88 107, 88 108, 88 112, 88 160, 88 161, 88 162, 88 271, 88 272, 88 273, 88 274, 88 275, 88 291	Urine cytology and cytogenetics
	Imaging studies	Continuous variable: number of unique claims over 2-year interval		71 010, 71 015, 71 020, 71 021, 71 022, 71 023, 71 030, 71 034, 71 035	Chest radiography
				71 250, 71 260, 71 270, 71 275	Chest CT
				71 550, 71 551, 71 552, 71 555	Chest MRI
				74 150, 74 160, 74 170	Abdominal CT
				74 181, 74 182, 74 183, 74 185	Abdominal MRI
				72 191, 72 192, 72 193, 72 194	Pelvis CT
				72 195, 72 196, 72 197	Pelvis MRI
				76 497	Unlisted CT
				76 498	Unlisted MRI
				78 810	PET scan
				74 400, 74 410, 74 415	Intravenous urography
				74 420	Retrograde urography
				74 425	Antegrade urography
				76 700, 76 770, 76 705, 76 775, 76 778	Abdominal or renal ultrasound
				78 700, 78 701, 78 704, 78 707, 78 708, 78 709, 78 715	Nuclear medicine renal scan
				78 300, 78 305, 78 306, 78 315, 78 320	Nuclear medicine bone scan
				78 800, 78 801, 78 802, 78 990	Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical agents
Treatment related	Intravesical therapy	Continuous variables: number of unique claims over 2-year interval; and, measure number of induction courses^† over 2-year interval		51 720	Bladder instillation of anticarcinogenic agent
Treatment related	Intravesical therapy	Dichotomous variable: use of induction chemotherapy at least once during 2-year interval		51 720	Bladder instillation of anticarcinogenic agent
				51 700	Bladder irrigation, with or without instillation
				51 701	Insertion of a nonindwelling catheter
				51 702, 51 703	Insertion of a temporary indwelling catheter
				J8520, J8521	Capecitabine
				J9000, J9001	Doxorubicin
				J9031	Intravesical Bacille Calmette-Guérin
				J9201	Gemcitabine
				J9280, J9290, J9291	Mitomycin
				J9340	Thiotepa
	Repeat endoscopic resection	Dichotomous variable: use of repeat endoscopic resection within 60 days of initial resection or biopsy	57.49	52 234, 52 235, 52 240	Cystoscopy, with fulguration and/or resection of small (0.5 up to 2 cm); medium (2 up to 5 cm); large (≥5 cm) tumors
Medical services	Visits to the urologist	Continuous variable: number of unique claims over 2-year interval		99 201–99 205	New patient, outpatient
				99 211–99 215	Established patient, outpatient
				99 218–99 220, 99 234–99 236	Initial, established, observation unit
				99 221–99 223	Initial, inpatient
				99 231–99 233	Subsequent, inpatient
				99 241–99 245	Consult, outpatient
				99 251–99 255	Consult, inpatient, new
				99 261–99 263	Consult, inpatient, established
				99 271–99 275	Confirmatory consult
	Visits to other physicians	Continuous variable: number of unique claims over 2-year interval		99 201–99 205	New patient, outpatient
				99 211–99 215	Established patient, outpatient
				99 218–99 220, 99 234–99 236	Initial, established, observation unit
				99 221–99 223	Initial, inpatient
				99 231–99 233	Subsequent, inpatient
				99 241–99 245	Consult, outpatient
				99 251–99 255	Consult, inpatient, new
				99 261–99 263	Consult, inpatient, established
				99 271–99 275	Confirmatory consult

ICD-9 = International Classification of Diseases, 9th Revision; MEDPAR = Medicare Provider Analysis and Review file; HCPCS = Healthcare Common Procedure Coding System; CT = computed tomography; MRI = magnetic resonance imaging; PET = positron emission tomography.

^†

Induction intravesical therapy: at least five unique claims for instillation of any anticarcinogenic agent within a 45-day period.