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    PROPOSAL
    Maryland Register
    Issue Date:  December 9, 2016
    Volume 43 • Issue 25• Pages 1404—1406
     
    Title 10
    DEPARTMENT OF HEALTH AND MENTAL HYGIENE
    Subtitle 14 CANCER CONTROL
    10.14.01 Cancer Registry
    Authority: Health-General Article, §§2-104, 18-104, 18-203, and 18-204, Annotated Code of Maryland; 42 U.S.C. §280(e)
    Notice of Proposed Action
    [16-321-P-I]
    The Secretary of Health and Mental Hygiene proposes to amend Regulations .01, .02, .02-1, and .07 under COMAR 10.14.01 Cancer Registry.
    Statement of Purpose
    The purpose of this action is to update the International Classification of Diseases, Clinical Modification codes listed in the regulations from the ninth (ICD-9-CM) to the tenth (ICD-10-CM) revision, and to update the incorporation by reference of the Maryland Cancer Registry Data Use Manual and Procedures to the most recent version (July 2016).
    Comparison to Federal Standards
    There is no corresponding federal standard to this proposed action.
    Estimate of Economic Impact
    The proposed action has no economic impact.
    Economic Impact on Small Businesses
    The proposed action has minimal or no economic impact on small businesses.
    Impact on Individuals with Disabilities
    The proposed action has no impact on individuals with disabilities.
    Opportunity for Public Comment
    Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through January 9, 2017. A public hearing has not been scheduled.
     
     Editor’s Note on Incorporation by Reference
                    Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the Maryland Cancer Registry Data Use Manual and Procedures, July 2016, has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories was published in 43:1 Md. R. 10 (January 8, 2016), and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.
    .01 Scope.
    This chapter establishes a cancer registry within the Department, defines key terms, details the information to be contained in a cancer report, and specifies requirements of reporting facilities, nursing facilities, assisted living programs, and general hospice care programs. In addition, this chapter identifies requestors authorized to receive confidential data, allows a fee to be charged for data reports, and incorporates by reference the Maryland Cancer Registry Data Use Manual and Procedures [(October 2012)] (July 2016).
    .02 Definitions.
    A. (text unchanged)
    B. Terms Defined.
    (1)—(3) (text unchanged)
    (4) Case of a Reportable Human CNS Tumor.
    (a) (text unchanged)
    (b) “Case of a reportable human CNS tumor” includes all benign and uncertain behavior tumors of the CNS ([ICD-9-CM] ICD-10-CM Codes [225.0—225.9, 227.3—227.4, 228.02, 237.0—237.1, 237.5—237.9, and 239.6] D18.02, D32.0D33.9, D35.2D35.4, D42.0D43.9, D44.3D44.5, Q85.00Q85.09 and D49.6, and all tumors of the CNS of benign and uncertain behavior with ICD-O-3 codes of “0” or “1”), which includes codes from:
    (i) The International Classification of Diseases, [Ninth] Tenth Revision, Clinical Modification [(ICD-9-CM)] (ICD-10-CM); and
    (ii) (text unchanged)
    (5) “Case of reportable human cancer” means the identification of a human cancer from the following list, which includes codes from the International Classification of Diseases, [Ninth] Tenth Revision, Clinical Modification [(ICD-9-CM)] (ICD-10-CM) and the International Classification of Diseases for Oncology, Third Edition (ICD-O-3):
    (a) All malignant neoplasms with [ICD-9-CM] ICD-10-CM Codes [140—195.8 and 199—209.37] C00C43.9, C44.00, C44.09, C44.10_, C44.19_, C44.20_, C44.29_, C44.30_, C44.39_, C44.40, C44.49, C44.50_, C44.59_, C44.60_, C44.69_, C44.70_, C44.79_, C44.80, C44.89, C44.90, C44.99, C45._C96._, or with ICD-O-3 behavior code of “3”, including genital skin cancer of the vagina, clitoris, vulva, prepuce, penis, and scrotum and excluding other sites of skin cancer with ICD-O-3 topography codes C44.0—C44.9 with one of the following ICD-O-3 histologies:
    (i)—(ii) (text unchanged)
    (iii) M-8050—8084 Papillary and squamous cell carcinomas of skin (C44.02, C44.12_, C44.22_, C44.32_, C44.42, C44.52_, C44.62_, C44.72_, C44.82, C44.92); or
    (iv) M-8090—8110 Basal cell carcinomas (C44.01, C44.11_, C44.21_, C44.31_, C44.41, C44.51_, C44.61_, C44.71_, C44.81, C44.91);
    (b) All malignant neoplasms with the following [ICD-9-CM] ICD-10-CM codes where ICD-O-3 behavior is “3” and ICD-O-3 histologies are reported except as follows:
    (i) If there is evidence of multiple foci, lymph node involvement, or metastasis, C37—Thymoma (M-8580);
    (ii) C7A.020Malignant carcinoid tumor of the appendix (M-8240);
    [(i)] (iii) [236.0] C54.1—Endometrial stroma, low grade (M-8931);
    (iv) If there is evidence of multiple foci, lymph node involvement, or metastasis, D48.1Stromal Tumor of the digestive system (GIST 8639);
    [(ii)] (v) [238.3] D48.60—Phylloides tumor (M-9020);
    [(iii)] (vi) [238.4] D45—Polycythema [(M-9960)] (M-9950);
    [(iv)] (vii) [238.6] D47.Z9—Plasmacytoma (M-9731, M-9734);
    [(v)] (viii) [238.71—238.79] D47.3—Essential thrombocythemia (M-9962), [myelodysplastic syndromes (M-9980, M-9982, M-9983, M-9985, M-9986, M-9987, M-9989), myelofibrosis with myeloid metaplasia (M-9961), post transplant lymphoproliferative disorder (M-9987) or lympho and myeloproliferative disease (M-9931, M-9960, M-9961)] D46.0, D46.1, D46.20, D46.21, D46A, D46BLow grade myelodysplastic syndrome lesions (M-9980), D46.22High grade myelodysplastic syndrome lesions (M-9983), D46.CMyelodysplastic syndrome with 5q deletion (M-9986), D469Myelodysplastic syndrome, unspecified (M-9975), D47.1Myelofibrosis with myeloid metaplasia (primary myelofibrosis) (M-9961), D47.Z1post-transplant lymphoproliferative disorder (M-9989), C94.40, C94.41, C94.42, D47.9, D47.Z9lympho and myeloproliferative disease (M-9960, M-9970);
    [(vi)] (ix) [273.2] C88.2—Alpha and gamma heavy chain disease (M-9762) or Franklin disease (M-9763);
    [(vii)] (x) [273.3] C88.0—Waldenstrom macroglobulinemia (M-9761);
    [(viii)] (xi) [284.9] D46.4—Refractory anemia (M-9980); or
    [(ix)] (xii) [285.0] D46.1—Refractory anemia with ringed sideroblasts (M-9982), refractory anemia with excess blasts (M-9983), or refractory anemia with excess blasts in transformation (M-9984);
    (c) All cases of carcinoma in situ with [ICD-9-CM] ICD-10-CM Codes [230.0—234.9] D00._—D09.9, D47.Z2, D49.511D49.519, D49.59, D78.31D78.34, and D89.40D89.49, or with ICD-O-3 behavior code of “2”, including genital skin cancers of the vagina, clitoris, vulva, prepuce, penis, and scrotum and excluding other skin cancers with ICD-O-3 topography codes C44.0_—C44.9_ with one of the following ICD-O-3 histologies:
    (i)—(iv) (text unchanged)
    (d) All cases of intraepithelial neoplasia with ICD-O-3 histology code of M-8077/2:
    (i) Including squamous intraepithelial neoplasia of the larynx (LIN), vagina (VAIN), vulva (VIN), and anus (AIN) ([ICD-9-CM] ICD-10-CM codes [233.3] D02.0, D07.2, D07.1, and [230.6] D01.3; and ICD-O-3 topography codes C52, C51, and [C21.1] C21._); and
    (ii) Excluding squamous intraepithelial neoplasia of the cervix (CIN III) and glandular intraepithelial neoplasia of the prostate (PIN) ([ICD-9-CM] ICD-10-CM codes [233.1] D06._ and [233.4] D07.5; and ICD-O-3 topography codes C53 and C61.9).
    (6)—(16) (text unchanged)
    .02-1 Incorporation by Reference.
    The Maryland Cancer Registry Data Use Manual and Procedures (Maryland Department of Health and Mental Hygiene, [October 2012] July 2016) is incorporated by reference.
    .07 Confidentiality of Cancer Reports.
    A.—F. (text unchanged)
    G. The Secretary shall release cancer data in accordance with the procedures outlined in the Maryland Cancer Registry Data Use Manual and Procedures [(October 2012)].
    VAN T. MITCHELL
    Secretary of Health and Mental Hygiene