SEER Inquiry System - View

Question: 20120068 Status
Final

References
Source 1:   Heme & Lymph Manual & DB
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Notes:  
Source 2:   Subject matter expert
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Notes:  


Question
Histology--Heme & Lymphoid Neoplasms: What is the correct histology code for a diagnosis of mature B cell leukemia/lymphoma diagnosed only on a peripheral blood smear?

Discussion


Answer
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Code the histology to 9591/3 [B-cell lymphoma, NOS].

After searching the Heme DB for the term leukemia/lymphoma, no B-cell leukemia/lymphoma NOS code is found. However, the diagnosis of B-cell lymphoblastic leukemia/lymphoma is found. This case scenario does not specify that this is a lymphoblastic leukemia/lymphoma; therefore, the histology code 9811/3 [B-cell lymphoblastic leukemia/lymphoma, NOS] cannot be applied.

A subsequent search of the Heme DB for the term B-cell lymphoma NOS returns “Non-Hodgkin lymphoma, NOS” [9591/3]. Under the Alternative Names section of the Heme DB, B-cell lymphoma, NOS, is a synonym for Non-Hodgkin lymphoma, NOS. Therefore, the B-cell lymphoma NOS code [9591/3] is the most appropriate histology code to use for this case.

This will be added to the next revision of the Heme DB and Manual.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

History
This SINQ question has been updated to the Hematopoietic & Lymphoid Neoplasm Manual & Database published January 2014. The original answer below was written based on the rules in 2012 For cases diagnosed 2012 and later, access the Hematopoietic Database at

http://seer.cancer.gov/tools/heme/.

Click on Hematopoietic Project. Click on Hematopoietic and Lymphoid Database. The 2012 Hematopoietic Coding Manual (PDF) button will appear to indicate the correct version of the program is available now for query.

Code the histology to B-cell lymphoma, NOS [9591/3]. The steps used to arrive at this decision are:

Step 1: Enter leukemia/lymphoma in the Heme DB to find the histology. Click on the SEARCH button. Multiple results are returned, however there is no B-cell leukemia/lymphoma NOS code. The patient is not stated to have B-cell lymphoblastic leukemia/lymphoma so none of these histology codes can be used.

Step 2: Search again. Enter B-cell lymphoma NOS in the Heme DB to find the histology. Click on the SEARCH button. Ensure that “Non-Hodgkin lymphoma, NOS” [9591/3] is highlighted on the screen.

Step 3: Scroll down to the ALTERNATIVE NAMES section. B-cell lymphoma, NOS, is a synonym for Non-Hodgkin lymphoma, NOS. Code the histology as 9591/3 [B-cell lymphoma NOS].

NOTE: The diagnosis does not specify that this is a lymphoblastic leukemia/lymphoma, so the histology code 9811/3 [B-cell lymphoblastic leukemia/lymphoma, NOS] cannot be applied. The B-cell lymphoma NOS code [9591/3] is the most appropriate code in this case.



Last Updated
06/30/2014

Date Finalized
08/29/2012