| Report | Question ID | Question | Discussion | Answer | Year |
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20000261 | EOD-Extension--Lymphoma: What code is used to represent a non-Hodgkin lymphoma presenting with involvement of an extralymphatic organ and lymph nodes on the opposite side of the diaphragm? | For cases diagnosed 1998-2003: Code the EOD-Extension field to 31 [30 + localized involvement of an extralymphatic organ or site; Stage III E]. | 2000 | |
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20000535 | EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the following phrases: "case staged as C" and "case staged as T3a"? See discussion. | Example: A prostatectomy was done on 6/29. The physician staged the case as a "C" on 7/2 and as T3a on 8/6. It appears the physician is interpreting the following pathology information as unilateral extracapsular extension: "The tumor on the right extends to the inked surface of the gland. In this area the capsule appears absent." Should pathologic extension be coded to unilateral extracapsular extension [42]?
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For cases diagnosed 1998-2003:
Yes. Use the best information available to stage this case. In this case, the best information is the physician's statement that the case is stage T3a. Without any additional information, the EOD-Extension field is coded to 42 [Unilateral extracapsular extension (pT3a)] on the basis of the T3a stage by the MD. When there is a conflict between different staging systems, default to the AJCC stage. |
2000 |
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20000422 | Surgery of Primary Site: Should laparoscopy be coded as exploratory surgery? See discussion. | Many surgeons are doing exploratory surgery with laparoscopy involving a very small incision, but they can examine organs and take biopsies. Should laparoscopy be coded as exploratory surgery? | For cases diagnosed 1/1/1998 and later: Exploratory surgical procedures, such as laparoscopic surgeries, are not coded in the Surgery of Primary Site field. | 2000 |
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20000512 | EOD-Extension/EOD-Lymph Nodes--Kaposi Sarcoma: What code is used to represent this field for a Kaposi sarcoma with no skin lesions but positive lymph node and bone marrow biopsies? | Code the EOD-Extension field to 13 [Visceral (e.g., pulmonary, gastrointestinal tract, spleen, other)], because of the positive bone marrow. Code the EOD-Lymph Nodes field to 3 [Both clinically enlarged palpable lymph nodes (adenopathy) and pathologically positive lymph nodes], for the pathologically positive node.
Note: Potential revision of the extension scheme will be referred to SEER Medical Advisory Group (SMAG). |
2000 | |
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20000259 | Histology (Pre-2007): What code is used to represent the histology for a "malignant invasive gastrointestinal stromal tumor (GIST)"? | For tumors diagnosed 2001-2006: Malignant GIST is coded 8936/3.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules. |
2000 | |
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20000430 | Histology (Pre-2007)--Colon: What code is used to represent histology when the surgeon describes a sessile polyp and the final path diagnosis is stated as: "Rectal sessile polyp: Invasive moderately differentiated adenocarcinoma" (pathologist does not state that it is "arising in a sessile polyp")? | For tumors diagnosed prior to 2007:
Code the Histology field to 8210/3 [adenocarcinoma arising in a polyp]. The structure in which this adenocarcinoma is arising, is a polyp.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules. |
2000 | |
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20000526 | EOD-Extension--Lung: Is bilateral pleural effusion coded as 72 [malignant pleural effusion] or 85 [metastasis]? See discussion. | Example: 10/30/98 CXR: Widespread malignancy, hilar, superior mediastinal masses, bilateral pleural effusions, fullness in soft tissue right neck.
11/01/98 CT chest/ABD: Extensive infiltrate mediastinum by radiolucent tumor mass that engulfs esophagus/trachea. Pleural effusion extends so low it apes ascites. Normal ABS/pelvis.
11/01/98 Pathology: FNA right supraclavicular lymph node: metastic oat cell ca. Sputum cytology reported to be negative. |
For cases diagnosed 1998-2003, code the EOD-Extension field to 72 [malignant pleural effusion; pleural effusion, NOS]. | 2000 |
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20000280 | Primary Site--Breast: Is there a hierarchy for coding subsite for breast cases when there is conflicting information in the physical exam, mammogram, operative and pathology reports as to the exact location of the primary? See discussion. | Example: Two mammograms were performed. One report indicates the lesion is at 12:00 and the other indicates it is in the upper central quadrant. However, the pathology report from the modified radical mastectomy specimen indicates the mass is in the UIQ.
According to one of our physicians, when a pathologist has a mastectomy specimen with attached axillary contents, the location of the lesion (subsite) is very accurate. |
Code the Primary Site field to C50.2 [upper inner quadrant]. In general, the priority for using information is pathologic, operative, and clinical findings. The pathology report would take precedence in this case. The 2004 SEER Program Code manual will include the following instructions for determining breast subsite. Priority Order for Coding Subsites Use the information from reports in the following priority order to code a subsite when the medical record contains conflicting information: 1 Pathology report 2 Operative report 3 Physical examination 4 Mammogram, ultrasound If the pathology proves invasive tumor in one subsite and insitu tumor in all other involved subsites, code to the subsite involved with invasive tumor. |
2000 |
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20000270 | EOD-Lymph Nodes--Lung: What code is used to represent this field when the only information is a description of: 1. "hilar mass" 2. "mediastinal mass" 3. "enlarged" or "greater than 1 cm" used to describe any of the lymph nodes listed under code 2 in the EOD Lymph Nodes field? |
For cases diagnosed 1998-2003:
Code EOD-Lymph Nodes fields as follows for the examples given:
1) 9 [Unknown; not stated] for a "hilar mass" 2) 2 [Mediastinal] for a "mediastinal mass" 3) 2 [Mediastinal] for "enlarged" or "greater than 1 cm," if used to describe any of the named lymph nodes listed under code 2 in the EOD-Lymph Nodes field. |
2000 | |
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20000844 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Colon: What codes are used to represent these fields when the pathology from a colon cancer resection describes 2/16 positive pericolonic lymph nodes and a "metastatic nodule in the pericolonic fat"? | For cases diagnosed 1998-2003:
Code the Number of Regional Lymph Nodes Positive field to 03 and the Number of Regional Lymph Nodes Examined field to 17. Each grossly detectable nodule in the pericolonic fat is counted as one regional lymph node. |
2000 |
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