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| Question: 20120075 |
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Status Final References Source 1: 2012 Heme & Lymph Manual & DB pgs: Notes: Source 2: pgs: Notes: Question Primary site--Heme & Lymphoid Neoplasms: How should primary site be coded when a bone marrow biopsy is not done? See discussion. Discussion Biopsy of a right neck lymph nodes was positive for lymphoma. Flow cytometry was positive for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. A bone marrow biopsy was not done. PET showed multiple involved lymph node areas of right cervical, mediastinal nodes and para-aortic area.
Per Module 3 in the Hematopoietic DB I see that I should code the histology to 9823/3 but my question is what the primary site should be. It says to code the primary site to the involved lymph node regions when there is No bone marrow involvement so I think that I should code the primary site to C778 but the instructions don't specifically address if there was no bone marrow or peripheral smear done. What are we supposed to do if there is no bone marrow done?
Since there was no bone marrow done, use the information available, which is the involvement of multiple lymph node chains. We will add this clarification to the next version of the manual.
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