Some computer edits identify errors. Others indicate possible errors that require manual review for resolution. To eliminate the need to review the same cases repeatedly, over-ride flags have been developed to indicate that data in a record (or records) have been reviewed and, while unusual, are correct.

This over-ride is used with the following edits in the NAACCR Metafile of the EDITS software:

• Primary Site, Behavior Code ICDO2 (SEER IF39)
  Primary Site, Behavior Code ICDO3 (SEER IF39)

Some edits check for code combinations that are possible, but quite rare. If the code combination generates an error message and review of the case indicates that the codes are correct for the case, then the over-ride flag is used to skip the edit in the future. See Standards for Cancer Registries, Standard Data Edits. 

Over-ride Flag as Used in the EDITS Software Package

Edits of the type, Primary Site, Behavior Code, require review of the following primary sites with a behavior of in situ (ICD-O-2 or ICD-O-3 behavior = 2):

• C269                Gastrointestinal tract, NOS
• C399                Ill-defined sites within respiratory system
• C559                Uterus, NOS
• C579                Female genital tract, NOS
• C639                Male genital organs, NOS
• C689                Urinary system, NOS
• C729                Nervous system, NOS
• C759                Endocrine gland, NOS
• C760-C768      Ill-defined sites
• C809                Unknown primary site

Since the designation of in situ is very specific and almost always requires microscopic confirmation, ordinarily specific information should also be available regarding the primary site. Conversely, if inadequate information is available to determine a specific primary site, it is unlikely that information about a cancer being in situ is reliable.

If an in situ diagnosis is stated, try to obtain a more specific primary site. A primary site within an organ system can sometimes be identified based on the diagnostic procedure or treatment given or on the histologic type. If no more specific site can be determined, it is usually preferable to code a behavior code of 3. In the exceedingly rare situation in which it is certain that the behavior is in situ and no more specific site code is applicable, set Over-ride Site/Behavior to 1.

Instructions for Coding

• Leave blank if the program does not generate an error message for the edit Primary Site, Behavior Code ICDO2 (SEER IF39) and/or the edit Primary Site, Behavior Code ICDO3 (SEER IF39).
• Leave blank and correct any errors for the case if an item is discovered to be incorrect.
• Code 1 if review of site and behavior verifies that the patient has an in situ cancer of a nonspecific site and no further information about the primary site is available.

Codes

Note: The IF 39 edit does not allow in situ cases of nonspecific sites, such as gastrointestinal tract, NOS; uterus, NOS; female genital tract, NOS; male genital organs, NOS; and others. The over-ride indicates that the conflict has been reviewed.