Rather than entering one exam at a time, via manual data entry, you may upload many exams at once using the batch data file upload process.
Note: You may upload data for multiple facilities simultaneously; however, if you leave the Facility ID blank for a row, that row will be uploaded to the Facility ID selected in the facility picker.
All data files must be either pipe-delimited text or Excel (xlsx) files. If desired, you may start with a blank Excel worksheet and follow the layout to add each field according to the format and values specified. The file may be uploaded as an xlsx file or be converted to a text (.txt) file. If this is your first time creating a file you may need to configure your computer to use the ‘|’ (vertical bar) character when converting the file.
NOTE: On the NRDR portal and accessible at this link, ACR has created templates which can be used to upload a file using an .XLSX format, where no file conversion is necessary before submitting.
NOTE: When uploading an Excel file, please ensure it does NOT have any formulas in the cells. This will cause the file to reject and potentially not allow the log file to be accessed.
Make sure you name your file according to the naming conventions outlined in the upload specifications (lcsr_exam_postfix.xlsx, where <postfix> is a required free text field of up to 50 characters).
The LCSR Exam data file specifications are as follows:
The maximum recommended file size is 40 MB.
The filename extension should be .txt or .xlsx.
The data file must contain at least one record.
Each line must contain one and only one record; the record delimiter is the CARRIAGE RETURN character followed by the LINE FEED character.
A header row is not required; if you are using the template, the header row is rejected during the upload, however, the remaining patient data are retained.
Each record must begin at the first position of a line.
Each record must have the correct number of data elements; blank data elements must be represented by a null character, not a space.
Each data element must be positioned in the order specified in the LCSR Data File Layout document.
If converting to a text file, each data element is separated by the vertical bar character ‘|’; if there is no answer for a data element you should write the ‘|’ character immediately after the previous ‘|’. Do not use the SPACE character to substitute for a null value.
Example: Using the first nine data elements (as listed in the File Layout) as an example, suppose we only have data for Patient first name, Patient last name, Patient Medicare ID, and we do not have the patient’s social security number, then the data should be written as:
The LCSR Data File Layout describes the format, valid values, and business rules for each data element. Some important guidelines to keep in mind:
Acceptable values: The LCSR upload process validates values and formats for most data elements. Refer to the Valid Values/Format column in the file layout for the acceptable values and data formats. For example:
Patient Social Security Number accepts only nine digits in the nnn-nn-nnnn format.
How Cause of Death was Determined accepts one value, the valid values are 1,2,3,4,5,6, or 8. The Mappings/Definitions column lists the options/text for each value.
The Reading Radiologist must exist in the NRDR Physician directory. If the physician record does not exist in the directory you can enter it online.
All dates must be in mm/dd/yyyy format.
Data elements that accept more than one value: If a data element accepts multiple answers, each value must be separated by the comma character ‘,’ in the data file. These data elements are indicated as “Select all that apply” in the Mapping/Definitions column. For example:
Cancer-related history accepts multiple values. If a patient has both Prior history of lung cancer (value 0) and Pulmonary fibrosis (value 5) then the data element should be entered as:
Data dependency: Some data elements may need to be populated depending on whether another element is populated or the value of another element. These conditions are listed in the Business Rules column of the file layout. For example:
One of the patient identifiers must be provided: Other ID, Patient SSN, or Medicare Beneficiary ID.
If Follow-up diagnostic is 4, 5 or 6, then Tissue Diagnosis is required. If Follow-up diagnostic value is 7, then Tissue Diagnosis is optional. Otherwise, Tissue diagnosis should be left blank.
Optional data elements: Data elements marked as Optional under the Business Rules column are not required to upload a record; that is, a record is not rejected if an optional field is missing. However, we do expect you to provide all data elements if the data are available. This expectation of complete data is specified in the participation agreement signed by all participating facilities and is essential to help make the LCSR data set as robust as possible.
Note: The Required to Submit a Transaction column in the file layout denotes the minimum fields required to successfully upload an exam record in LCSR. Failure to include one or more of the required data elements causes the record to be rejected.
The Business Rules column applies to all data submission methods and defines the fields required to create a complete exam/follow-up record and move the exam status to Submitted. An exam remains In Progress until all required fields have been populated. You can update missing data elements by resubmitting the exam via Data File Upload or by manually entering the missing data
The key identifier for an exam record is the exam date and patient ID (Patient SSN, Medicare Beneficiary ID, or Other ID). If you want to update an existing record in the LCSR database you can submit new record(s) with the same key identifier. The system ignores data elements with no values in the subsequent records. To clear any values you must use the LCSR Exam form on the NRDR portal to manually remove them.
When an exam record is uploaded with data missing for one or more required or conditionally required data elements, warning messages are generated in the log file and the exam is created with an In Progress status. You must use the LCSR Exam form on the NRDR portal to manually populate the missing data and then submit the exam to change the status to Submitted. Alternatively, you can also upload a new record with the same key (Patient ID and exam date) and with all valid data for all required elements to change the status to Submitted.
Note: You must submit all Required or Conditionally Required data elements, as indicated in the Business Rules column of the file layout, in order to move the exam from In Progress to Submitted status.
Refer to "What Follow-Up Procedures should be Reported?" on the LCSR FAQs page for an explanation of what constitutes a follow-up procedure.
The relationship between Exam and Follow-up records is one-to-many. If you are submitting multiple follow-up records for an exam in the same data file, each follow-up record must be submitted on a separate row with the same key identifiers on the exam record. Key identifiers are:
- Facility ID
- Patient Social Security Number
- Old Medicare Beneficiary ID (in effect prior to April 2018)
- New Medicare Beneficiary ID (in effect after April 2018)
- Other ID
- Date of screening exam
If more than one exam exists for a patient, enter the follow-up record(s) for the most recent exam form whose exam date is less than or equal to the date of the follow-up.
Uploading the File
Once your file is ready, follow the Data File Upload process to upload the file to the registry. Be sure to check the file status to see if there are errors you need to investigate or correct.
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