SEER Inquiry System - Report
Produced: 12/26/2024 8:37 AM
Question 20010155
Inquiry Details
References:
2004 SEER Manual, 3
Question:
Reportability/Diagnostic Confirmation--Melanoma: Would a shave biopsy diagnosis of "highly suggestive of early melanoma", followed by a re-excision diagnosis of "no residual disease", be SEER reportable if the clinician referred to the case clinically as a melanoma? If so, what would the Diagnostic Confirmation be? See discussion.
Discussion:
Pathology report from a shave biopsy states: "...markedly atypical junctional melanocytic proliferation. Changes highly suggestive of early melanoma arising adjacent to superficial congenital nevus." The re-excision pathology report states "biopsy proven melanoma" in the "Clinical History" section of the report (which is a reference to the original shave biopsy). The re-excision final pathology diagnosis states "no evidence of melanoma." The physician states that he thinks this is a melanoma. Should it be reported? Should Diagnostic Confirmation be coded to 1 or 8?
Answer:
The case is reportable because the physician documented a clinical diagnosis of malignant melanoma. Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only (other than 5, 6 or 7)].