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The Canadian Joint Replacement Registry (CJRR) is a pan-Canadian medical device registry that collects patient-specific information (clinical, surgical and prosthesis) on hip and knee replacement surgeries performed in Canada. This data supports quality-of-care and outcome monitoring for hip and knee replacement patients. Therefore, it is essential that data providers accurately capture product information for implants and cements.

CJRR data can be submitted via the Discharge Abstract Database (DAD) or the legacy CJRR electronic file submission system. Both systems accept product and lot numbers that have been entered using a barcode scanner or by manual entry. A built-in system algorithm identifies scanned data and extracts the necessary product and lot information.

Since product stickers are not standardized across and even within manufacturers, data providers must take care to ensure that the correct barcode is entered and appears in the appropriate data field (i.e., Product Number versus Lot Number).

Product numbers are unique within manufacturers, so it is important to code the correct manufacturer when submitting prosthesis information. For example, any sticker that indicates the manufacturer JOHNSON or JOHNSON & JOHNSON should be coded under Manufacturer code 3: DePuy/Finsbury/J & J. 

Note: All samples of product stickers provided below are fictitious yet resemble actual product stickers from a variety of manufacturers.

For vendor-based systems that already support barcode scanning as part of their CJRR data capture systems, the CJRR team recommends that data providers maintain their existing business processes. In these instances, the correct product and lot number are already being extracted from the barcodes and submitted to CJRR.

Getting started with a barcode scanner

Step 1: Setting up your barcode scanner

The first step is to enable transmission of the Automatic Identification and Mobility (AIM) Code. Please refer to your scanner’s user manual for more information. Scanner settings are often enabled or disabled by scanning special barcodes provided in the user manual.

Enabling the AIM Code is necessary for the CJRR system to recognize the entry as a scanned barcode rather than a manually entered value. Without the AIM Code, the CJRR system will not extract the necessary product and lot information.

Step 2: Verifying that AIM Code transmission is enabled

To verify that the AIM code transmission is enabled, please scan the barcode below. Onscreen, you should see the following: ]C0123456789. Note the right square bracket ( ] ) at the beginning of the output.

Note: The language of your keyboard affects how a barcode scanner reads data; only the keyboard languages “US” (English) and “Canadian French” are supported by the CJRR system. “Canadian Multilingual Standard” and all other keyboard languages are not supported.

French keyboard users: In place of the leading right square bracket, the scanned output will lead with a cedilla (either “¸” or “Ç”).

Scanning and entering product information

This section outlines specific instructions for entering product information from the sticker. Currently, product stickers are not standardized across manufacturers and, sometimes, within manufacturer lines. Please study the variations in stickers in your facility to become familiar with how they should be entered using the instructions below.

With the AIM Code enabled, each scanned barcode should lead with a right square bracket (“]”). If this is missing, it may be an indication that the AIM Code was not enabled (see Step 1). French keyboard users: In place of the leading square bracket, scanned output will lead with a cedilla (either “¸” or “Ç”).

Sticker submission in DAD: Each component can have up to 7 sticker occurrences to capture all parts associated with the component. For cases that have fewer than 7 sticker occurrences, you need to submit only the occurrences required for your particular record and leave the remaining occurrences blank. For example, if there are only 2 stickers available for a particular record, submit only 2 occurrences and leave sticker data elements blank for the remaining 5 occurrences.

Note: In a few circumstances, there are special handling exceptions for certain manufacturers. Across all stickers, the terms “catalogue number” and “reference number” are used interchangeably.

a) Stickers with 2 barcodes

In most cases, there will be character strings below each barcode; they contain the catalogue or reference number (top barcode) and the lot number (bottom barcode).

Link products: Do not scan the barcodes. The product and lot numbers need to be entered manually.

All other manufacturers: Scan the top barcode into the Product Number field and the bottom barcode into the Lot Number field. The scanned output may contain additional symbols or numbers. Do not edit or change the character string that appears in the scanned output. Alternatively, manually enter the catalogue/reference number into the Product Number field and the lot number into the Lot Number field.

Example 1

Note
*   For Link products, manually enter the product/reference and lot numbers exactly as they are shown (for example 1, for the reference number, enter 1234-5-6789, and for the lot number, enter 123456789).

Example 2

b) Stickers with a single barcode

Zimmer products: Zimmer product stickers contain 1 barcode that has both the catalogue/reference number and lot number embedded in the character string below the single barcode. Scan the barcode into the Product Number field and again into the Lot Number field. Alternatively, manually enter the catalogue/reference number into the Product Number field and the lot number into the Lot Number field.

Smith & Nephew or Biomet products, or Palacos cements: For Smith & Nephew and Biomet products or Palacos cements (with only 1 one-dimensional linear barcode), manually enter or scan the barcode into the Product Number field and enter “UNK” or the lot number into the Lot Number field.

Cerafix and all other manufacturers: Manually enter the catalogue/reference number into the Product Number field and the lot number into the Lot Number field.

c) Stickers with a two-dimensional (2D) barcode

If both one-dimensional (linear) and two-dimensional (square, data matrix) barcodes are available, scan or manually enter the one-dimensional barcode(s) according to the above instructions.

If only a square 2D barcode is available, scan the 2D barcode into the Product Number field and enter “UNK” into the Lot Number field. Alternatively, manually enter the catalogue/reference number into the Product Number field and the lot number into the Lot Number field.

Note: A compatible scanner is required to scan two-dimensional barcodes.      

d) Stickers with no barcodes

Manually enter the catalogue/reference number into the Product Number field and the lot number into the Lot Number field. Include any dashes, as shown below.

For Zimmer products, the product number is often referred to as the EDI number.

• If there is an EDI number, manually enter it in the implant Product Number field.
• If there is no EDI number, manually enter the catalogue number (also known as the reference number) in the implant Product Number field.

e) Stickers with missing or unknown barcodes in DAD

In cases where a product’s information is not available and coders are unable to obtain it from the surgeon or operating room staff, coders can complete the occurrence as follows:

When cement bar code stickers are missing, please complete Group 20 Cement Sticker Information as follows:

• 20/03 = OTH
• 20/04 = Enter Manufacturer if known, otherwise enter STICKERMISS
• 20/05 = PRODMISS
• 20/06 = LOTMISS

When cement bar code stickers are damaged, cannot be scanned or manually entered, please complete Group 20 Cement Sticker Information as follows:

• 20/03 = OTH
• 20/04 = Enter Manufacturer if known, otherwise enter STICKERDAMAGED
• 20/05 = PRODDAMAGED
• 20/06 = LOTDAMAGED

When component bar code stickers are missing, please complete Group 20 Component Sticker Information as follows:

• 20/08 = OTH
• 20/09 = Enter Manufacturer if known, otherwise enter STICKERMISS
• 20/10 = PRODMISS
• 20/11 = LOTMISS

When component bar code stickers are damaged, cannot be scanned or manually entered, please complete Group 20 Component Sticker Information as follows:

• 20/08 = OTH
• 20/09 = Enter Manufacturer if known, otherwise enter STICKERDAMAGED
• 20/10 = PRODDAMAGED20/11 = LOTDAMAGED

f) Stickers with missing or unknown barcodes in the legacy CJRR electronic file system

In cases where a product’s information is missing or damaged, data providers can complete the occurrence as follows:

• Product number = UNK
• Lot number = UNK
• Manufacturer= Select "Other/Autre" and enter "Missing"

For more information

Product labelling can change over time. We kindly ask data providers to report any discrepancies, new sticker variations or issues to cjrr@cihi.ca.