Cancer Pathology Data Sharing
2.0.0-ballot - STU 2 Ballot
Cancer Pathology Data Sharing
2.0.0-ballot - STU 2 Ballot
This page is part of the Sharing eCC Data from Pathology Labs to EHR (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. This version is a pre-release. The current official version is 1.0.1. For a full list of available versions, see the Directory of published versions
| Page standards status: Trial-use |
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<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem cap-ecc-codesystem</b></p><a name="cap-ecc-codesystem"> </a><a name="hccap-ecc-codesystem"> </a><a name="cap-ecc-codesystem-en-US"> </a><p>This case-insensitive code system <code>http://hl7.org/fhir/us/cancer-reporting/CodeSystem/cap-ecc-codesystem</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style="white-space:nowrap">31357.100004300<a name="cap-ecc-codesystem-31357.46100004300"> </a></td><td>Greatest dimension of largest invasive focus greater than 1 mm (specify exact measurement in Millimeters (mm))</td></tr><tr><td style="white-space:nowrap">30148.100004300<a name="cap-ecc-codesystem-30148.46100004300"> </a></td><td>Tumor Size (Note E)</td></tr><tr><td style="white-space:nowrap">51180.100004300<a name="cap-ecc-codesystem-51180.46100004300"> </a></td><td>Tumor Site (Note B)</td></tr><tr><td style="white-space:nowrap">16448.100004300<a name="cap-ecc-codesystem-16448.46100004300"> </a></td><td>Single focus of invasive carcinoma</td></tr><tr><td style="white-space:nowrap">38392.100004300<a name="cap-ecc-codesystem-38392.46100004300"> </a></td><td>Tumor Focality (Note F)</td></tr><tr><td style="white-space:nowrap">16214.100004300<a name="cap-ecc-codesystem-16214.46100004300"> </a></td><td>Specimen Laterality</td></tr><tr><td style="white-space:nowrap">16215.100004300<a name="cap-ecc-codesystem-16215.46100004300"> </a></td><td>Right</td></tr><tr><td style="white-space:nowrap">52399.100004300<a name="cap-ecc-codesystem-52399.46100004300"> </a></td><td>HER2 (by immunohistochemistry)</td></tr><tr><td style="white-space:nowrap">36944.100004300<a name="cap-ecc-codesystem-36944.46100004300"> </a></td><td>HER2 (by immunohistochemistry)</td></tr><tr><td style="white-space:nowrap">43789.100004300<a name="cap-ecc-codesystem-43789.46100004300"> </a></td><td>Breast Biomarker Testing Performed on Previous Biopsy</td></tr><tr><td style="white-space:nowrap">41776.100004300<a name="cap-ecc-codesystem-41776.46100004300"> </a></td><td>Estrogen Receptor (ER)</td></tr><tr><td style="white-space:nowrap">45138.100004300<a name="cap-ecc-codesystem-45138.46100004300"> </a></td><td>Estrogen Receptor (ER) Status</td></tr><tr><td style="white-space:nowrap">53472.100004300<a name="cap-ecc-codesystem-53472.46100004300"> </a></td><td>Cannot be determined (indeterminate)</td></tr><tr><td style="white-space:nowrap">16280.100004300<a name="cap-ecc-codesystem-16280.46100004300"> </a></td><td>Invasive carcinoma of no special type (ductal)</td></tr><tr><td style="white-space:nowrap">41794.100004300<a name="cap-ecc-codesystem-41794.46100004300"> </a></td><td>Histologic Type (Note C)</td></tr><tr><td style="white-space:nowrap">16182.100004300<a name="cap-ecc-codesystem-16182.46100004300"> </a></td><td>SPECIMEN</td></tr><tr><td style="white-space:nowrap">17834.100004300<a name="cap-ecc-codesystem-17834.46100004300"> </a></td><td>SPECIAL STUDIES</td></tr><tr><td style="white-space:nowrap">39858.100004300<a name="cap-ecc-codesystem-39858.46100004300"> </a></td><td>Regional Lymph Nodes</td></tr><tr><td style="white-space:nowrap">16697.100004300<a name="cap-ecc-codesystem-16697.46100004300"> </a></td><td>REGIONAL LYMPH NODES (Note M)</td></tr><tr><td style="white-space:nowrap">16717.100004300<a name="cap-ecc-codesystem-16717.46100004300"> </a></td><td>PATHOLOGIC STAGE CLASSIFICATION (pTNM, AJCC 8th Edition) (Note M)</td></tr><tr><td style="white-space:nowrap">16567.100004300<a name="cap-ecc-codesystem-16567.46100004300"> </a></td><td>MARGINS (Note L)</td></tr><tr><td style="white-space:nowrap">868263.100004300<a name="cap-ecc-codesystem-868263.46100004300"> </a></td><td>Lymph Nodes</td></tr><tr><td style="white-space:nowrap">352333.100004300<a name="cap-ecc-codesystem-352333.46100004300"> </a></td><td>DISTANT METASTASIS</td></tr><tr><td style="white-space:nowrap">381061.100004300<a name="cap-ecc-codesystem-381061.46100004300"> </a></td><td>COMMENTS</td></tr><tr><td style="white-space:nowrap">16782.100004300<a name="cap-ecc-codesystem-16782.46100004300"> </a></td><td>ADDITIONAL FINDINGS (Note N)</td></tr><tr><td style="white-space:nowrap">351607.100004300<a name="cap-ecc-codesystem-351607.46100004300"> </a></td><td>?Number of Sentinel Nodes Examined (if applicable)</td></tr><tr><td style="white-space:nowrap">351606.100004300<a name="cap-ecc-codesystem-351606.46100004300"> </a></td><td>Exact number (specify)</td></tr><tr><td style="white-space:nowrap">351601.100004300<a name="cap-ecc-codesystem-351601.46100004300"> </a></td><td>Exact number (specify)</td></tr><tr><td style="white-space:nowrap">351602.100004300<a name="cap-ecc-codesystem-351602.46100004300"> </a></td><td>Total Number of Lymph Nodes Examined (sentinel and non-sentinel)</td></tr><tr><td style="white-space:nowrap">374353.100004300<a name="cap-ecc-codesystem-374353.46100004300"> </a></td><td>Regional lymph nodes present</td></tr><tr><td style="white-space:nowrap">351589.100004300<a name="cap-ecc-codesystem-351589.46100004300"> </a></td><td>Regional Lymph Node Status</td></tr><tr><td style="white-space:nowrap">16736.100004300<a name="cap-ecc-codesystem-16736.46100004300"> </a></td><td>pT1b: Tumor > 5 mm but <= 10 mm in greatest dimension</td></tr><tr><td style="white-space:nowrap">327740.100004300<a name="cap-ecc-codesystem-327740.46100004300"> </a></td><td>pT Category</td></tr><tr><td style="white-space:nowrap">763178.100004300<a name="cap-ecc-codesystem-763178.46100004300"> </a></td><td>pN Category</td></tr><tr><td style="white-space:nowrap">38649.100004300<a name="cap-ecc-codesystem-38649.46100004300"> </a></td><td>pN0: No regional lymph node metastasis identified or ITCs only#</td></tr><tr><td style="white-space:nowrap">58807.100004300<a name="cap-ecc-codesystem-58807.46100004300"> </a></td><td>Procedure (Note A)</td></tr><tr><td style="white-space:nowrap">40307.100004300<a name="cap-ecc-codesystem-40307.46100004300"> </a></td><td>Excision (less than total mastectomy)</td></tr><tr><td style="white-space:nowrap">38391.100004300<a name="cap-ecc-codesystem-38391.46100004300"> </a></td><td>Overall Grade</td></tr><tr><td style="white-space:nowrap">16390.100004300<a name="cap-ecc-codesystem-16390.46100004300"> </a></td><td>Grade 1 (scores of 3, 4 or 5)</td></tr><tr><td style="white-space:nowrap">380283.100004300<a name="cap-ecc-codesystem-380283.46100004300"> </a></td><td>Nottingham Score</td></tr><tr><td style="white-space:nowrap">38125.100004300<a name="cap-ecc-codesystem-38125.46100004300"> </a></td><td>Nuclear Pleomorphism</td></tr><tr><td style="white-space:nowrap">16355.100004300<a name="cap-ecc-codesystem-16355.46100004300"> </a></td><td>Score 2 (Cells larger than normal with open vesicular nuclei, visible nucleoli, and moderate variability in both size and shape)</td></tr><tr><td style="white-space:nowrap">16383.100004300<a name="cap-ecc-codesystem-16383.46100004300"> </a></td><td>Score 1</td></tr><tr><td style="white-space:nowrap">38390.100004300<a name="cap-ecc-codesystem-38390.46100004300"> </a></td><td>Mitotic Rate</td></tr><tr><td style="white-space:nowrap">351503.100004300<a name="cap-ecc-codesystem-351503.46100004300"> </a></td><td>?Margin Status for Invasive Carcinoma (required only if residual invasive carcinoma is present in specimen)</td></tr><tr><td style="white-space:nowrap">351504.100004300<a name="cap-ecc-codesystem-351504.46100004300"> </a></td><td>All margins negative for invasive carcinoma</td></tr><tr><td style="white-space:nowrap">351501.100004300<a name="cap-ecc-codesystem-351501.46100004300"> </a></td><td>Lateral</td></tr><tr><td style="white-space:nowrap">16348.100004300<a name="cap-ecc-codesystem-16348.46100004300"> </a></td><td>Score 2 (10 to 75% of tumor area forming glandular / tubular structures)</td></tr><tr><td style="white-space:nowrap">38124.100004300<a name="cap-ecc-codesystem-38124.46100004300"> </a></td><td>Glandular (Acinar) / Tubular Differentiation</td></tr><tr><td style="white-space:nowrap">44040.100004300<a name="cap-ecc-codesystem-44040.46100004300"> </a></td><td>Ductal Carcinoma In Situ (DCIS) (Note G)</td></tr><tr><td style="white-space:nowrap">16306.100004300<a name="cap-ecc-codesystem-16306.46100004300"> </a></td><td>Not identified</td></tr><tr><td style="white-space:nowrap">352343.100004300<a name="cap-ecc-codesystem-352343.46100004300"> </a></td><td>?Not applicable</td></tr><tr><td style="white-space:nowrap">42418.100004300<a name="cap-ecc-codesystem-42418.46100004300"> </a></td><td>Clock position</td></tr><tr><td style="white-space:nowrap">352334.100004300<a name="cap-ecc-codesystem-352334.46100004300"> </a></td><td>?Distant Site(s) Involved, if applicable</td></tr><tr><td style="white-space:nowrap">16259.100004300<a name="cap-ecc-codesystem-16259.46100004300"> </a></td><td>Specify Clock Position</td></tr><tr><td style="white-space:nowrap">6643.100004300<a name="cap-ecc-codesystem-6643.46100004300"> </a></td><td>8 o'clock</td></tr><tr><td style="white-space:nowrap">16783.100004300<a name="cap-ecc-codesystem-16783.46100004300"> </a></td><td>Additional Findings (specify)</td></tr><tr><td style="white-space:nowrap">31359.100004300<a name="cap-ecc-codesystem-31359.46100004300"> </a></td><td>Additional Dimension in Millimeters (mm)</td></tr><tr><td style="white-space:nowrap">Breast.Invasive.Res.189_4.009.021.REL_sdcFDF<a name="cap-ecc-codesystem-Breast.46Invasive.46Res.46189_4.46009.46021.46REL_sdcFDF"> </a></td><td>INVASIVE CARCINOMA OF THE BREAST: Resection</td></tr><tr><td style="white-space:nowrap">16249.100004300<a name="cap-ecc-codesystem-16249.46100004300"> </a></td><td>TUMOR</td></tr><tr><td style="white-space:nowrap">16403.100004300<a name="cap-ecc-codesystem-16403.46100004300"> </a></td><td>Tumor Extent (Note H)</td></tr><tr><td style="white-space:nowrap">868258.100004300<a name="cap-ecc-codesystem-868258.46100004300"> </a></td><td>Primary Tumor Bed</td></tr><tr><td style="white-space:nowrap">868272.100004300<a name="cap-ecc-codesystem-868272.46100004300"> </a></td><td>RCB Calculations</td></tr></table></div>
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<valueCanonical
value="http://hl7.org/fhir/us/cancer-reporting/ImplementationGuide/hl7.fhir.us.cancer-reporting"/>
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<url
value="http://hl7.org/fhir/us/cancer-reporting/CodeSystem/cap-ecc-codesystem"/>
<version value="2.0.0-ballot"/>
<name value="CAPeCCCodeSystem"/>
<title value="CAP eCC CodeSystem"/>
<status value="active"/>
<experimental value="false"/>
<date value="2025-03-31T19:51:27+00:00"/>
<publisher
value="HL7 International / Orders and Observations and College of American Pathologists"/>
<contact>
<name
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<description value="A CodeSystem for CAP eCC codes"/>
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<code value="US"/>
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<caseSensitive value="false"/>
<content value="complete"/>
<count value="63"/>
<concept>
<code value="31357.100004300"/>
<display
value="Greatest dimension of largest invasive focus greater than 1 mm (specify exact measurement in Millimeters (mm))"/>
</concept>
<concept>
<code value="30148.100004300"/>
<display value="Tumor Size (Note E)"/>
</concept>
<concept>
<code value="51180.100004300"/>
<display value="Tumor Site (Note B)"/>
</concept>
<concept>
<code value="16448.100004300"/>
<display value="Single focus of invasive carcinoma"/>
</concept>
<concept>
<code value="38392.100004300"/>
<display value="Tumor Focality (Note F)"/>
</concept>
<concept>
<code value="16214.100004300"/>
<display value="Specimen Laterality"/>
</concept>
<concept>
<code value="16215.100004300"/>
<display value="Right"/>
</concept>
<concept>
<code value="52399.100004300"/>
<display value="HER2 (by immunohistochemistry)"/>
</concept>
<concept>
<code value="36944.100004300"/>
<display value="HER2 (by immunohistochemistry)"/>
</concept>
<concept>
<code value="43789.100004300"/>
<display value="Breast Biomarker Testing Performed on Previous Biopsy"/>
</concept>
<concept>
<code value="41776.100004300"/>
<display value="Estrogen Receptor (ER)"/>
</concept>
<concept>
<code value="45138.100004300"/>
<display value="Estrogen Receptor (ER) Status"/>
</concept>
<concept>
<code value="53472.100004300"/>
<display value="Cannot be determined (indeterminate)"/>
</concept>
<concept>
<code value="16280.100004300"/>
<display value="Invasive carcinoma of no special type (ductal)"/>
</concept>
<concept>
<code value="41794.100004300"/>
<display value="Histologic Type (Note C)"/>
</concept>
<concept>
<code value="16182.100004300"/>
<display value="SPECIMEN"/>
</concept>
<concept>
<code value="17834.100004300"/>
<display value="SPECIAL STUDIES"/>
</concept>
<concept>
<code value="39858.100004300"/>
<display value="Regional Lymph Nodes"/>
</concept>
<concept>
<code value="16697.100004300"/>
<display value="REGIONAL LYMPH NODES (Note M)"/>
</concept>
<concept>
<code value="16717.100004300"/>
<display
value="PATHOLOGIC STAGE CLASSIFICATION (pTNM, AJCC 8th Edition) (Note M)"/>
</concept>
<concept>
<code value="16567.100004300"/>
<display value="MARGINS (Note L)"/>
</concept>
<concept>
<code value="868263.100004300"/>
<display value="Lymph Nodes"/>
</concept>
<concept>
<code value="352333.100004300"/>
<display value="DISTANT METASTASIS"/>
</concept>
<concept>
<code value="381061.100004300"/>
<display value="COMMENTS"/>
</concept>
<concept>
<code value="16782.100004300"/>
<display value="ADDITIONAL FINDINGS (Note N)"/>
</concept>
<concept>
<code value="351607.100004300"/>
<display value="?Number of Sentinel Nodes Examined (if applicable)"/>
</concept>
<concept>
<code value="351606.100004300"/>
<display value="Exact number (specify)"/>
</concept>
<concept>
<code value="351601.100004300"/>
<display value="Exact number (specify)"/>
</concept>
<concept>
<code value="351602.100004300"/>
<display
value="Total Number of Lymph Nodes Examined (sentinel and non-sentinel)"/>
</concept>
<concept>
<code value="374353.100004300"/>
<display value="Regional lymph nodes present"/>
</concept>
<concept>
<code value="351589.100004300"/>
<display value="Regional Lymph Node Status"/>
</concept>
<concept>
<code value="16736.100004300"/>
<display
value="pT1b: Tumor > 5 mm but <= 10 mm in greatest dimension"/>
</concept>
<concept>
<code value="327740.100004300"/>
<display value="pT Category"/>
</concept>
<concept>
<code value="763178.100004300"/>
<display value="pN Category"/>
</concept>
<concept>
<code value="38649.100004300"/>
<display
value="pN0: No regional lymph node metastasis identified or ITCs only#"/>
</concept>
<concept>
<code value="58807.100004300"/>
<display value="Procedure (Note A)"/>
</concept>
<concept>
<code value="40307.100004300"/>
<display value="Excision (less than total mastectomy)"/>
</concept>
<concept>
<code value="38391.100004300"/>
<display value="Overall Grade"/>
</concept>
<concept>
<code value="16390.100004300"/>
<display value="Grade 1 (scores of 3, 4 or 5)"/>
</concept>
<concept>
<code value="380283.100004300"/>
<display value="Nottingham Score"/>
</concept>
<concept>
<code value="38125.100004300"/>
<display value="Nuclear Pleomorphism"/>
</concept>
<concept>
<code value="16355.100004300"/>
<display
value="Score 2 (Cells larger than normal with open vesicular nuclei, visible nucleoli, and moderate variability in both size and shape)"/>
</concept>
<concept>
<code value="16383.100004300"/>
<display value="Score 1"/>
</concept>
<concept>
<code value="38390.100004300"/>
<display value="Mitotic Rate"/>
</concept>
<concept>
<code value="351503.100004300"/>
<display
value="?Margin Status for Invasive Carcinoma (required only if residual invasive carcinoma is present in specimen)"/>
</concept>
<concept>
<code value="351504.100004300"/>
<display value="All margins negative for invasive carcinoma"/>
</concept>
<concept>
<code value="351501.100004300"/>
<display value="Lateral"/>
</concept>
<concept>
<code value="16348.100004300"/>
<display
value="Score 2 (10 to 75% of tumor area forming glandular / tubular structures)"/>
</concept>
<concept>
<code value="38124.100004300"/>
<display value="Glandular (Acinar) / Tubular Differentiation"/>
</concept>
<concept>
<code value="44040.100004300"/>
<display value="Ductal Carcinoma In Situ (DCIS) (Note G)"/>
</concept>
<concept>
<code value="16306.100004300"/>
<display value="Not identified"/>
</concept>
<concept>
<code value="352343.100004300"/>
<display value="?Not applicable"/>
</concept>
<concept>
<code value="42418.100004300"/>
<display value="Clock position"/>
</concept>
<concept>
<code value="352334.100004300"/>
<display value="?Distant Site(s) Involved, if applicable"/>
</concept>
<concept>
<code value="16259.100004300"/>
<display value="Specify Clock Position"/>
</concept>
<concept>
<code value="6643.100004300"/>
<display value="8 o'clock"/>
</concept>
<concept>
<code value="16783.100004300"/>
<display value="Additional Findings (specify)"/>
</concept>
<concept>
<code value="31359.100004300"/>
<display value="Additional Dimension in Millimeters (mm)"/>
</concept>
<concept>
<code value="Breast.Invasive.Res.189_4.009.021.REL_sdcFDF"/>
<display value="INVASIVE CARCINOMA OF THE BREAST: Resection"/>
</concept>
<concept>
<code value="16249.100004300"/>
<display value="TUMOR"/>
</concept>
<concept>
<code value="16403.100004300"/>
<display value="Tumor Extent (Note H)"/>
</concept>
<concept>
<code value="868258.100004300"/>
<display value="Primary Tumor Bed"/>
</concept>
<concept>
<code value="868272.100004300"/>
<display value="RCB Calculations"/>
</concept>
</CodeSystem>
IG © 2025+ HL7 International / Orders and Observations and College of American Pathologists. Package hl7.fhir.us.cancer-reporting#2.0.0-ballot based on FHIR 4.0.1. Generated 2025-03-31
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