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SEER Inquiry System - Report
Produced: 11/24/2024 3:28 PM
Question 20031060
Inquiry Details
References:
ICD-O-3, 102-103
Question:
Histology--Hematopoietic, NOS: Because histology 9895/3 [Acute myeloid leukemia with multilineage dysplasia] was recognized as a distinct entity by WHO with too few cases of the subtypes [with or without prior MDS] to warrant separate histology codes for each, should the wording for the non-bold definitions in ICD-O-3 be changed to the following in both the alpha and numeric sections? See Description.
AML with multilineage dysplasia and prior MDS
AML with multilineage dysplasia and without prior MDS
Discussion:
How do we code histology for the following case of AML?
Patient was admitted for profound anemia and thrombocytopenia with
no immediate explanation. Path final diagnosis on bone marrow biopsy: acute myelogenous leukemia (AML). Per micro description: findings are
characteristic of AML that appears to be arising within the context of a myelodysplastic syndrome. The discharge diagnosis (2 days after bone marrow biopsy) read: myelodysplastic syndrome with profound anemia and
thrombocytopenia.
Do we code the histology per the final path diagnosis (code 9861/3)?
Using the current version of ICD-O-3, we could arrive at a histology code of 9895/3 based on the micro findings of AML with prior myelodysplastic syndrome. However, per the above-mentioned SEER e-mail, we would not because there was no mention of multilineage dysplasia.
Answer:
For cases diagnosed prior to 1/1/2010:To assign code 9895, it is important that the diagnosis includes "multilineage dysplasia." Use code 9895 when the diagnosis is with or without prior (not concurrent) myelodysplastic syndrome AND multilineage dysplasia. Acute myeloid leukemia without prior myelodysplastic syndrome and without multilineage dysplasia is coded 9861 [Acute myeloid leukemia, NOS].
Although the wording of 9895 cannot be changed, coders can make a note that the synonyms are intended to include:
-Acute myeloid leukemia WITH multilineage dysplasia with prior myelodysplastic syndrome
and
-Acute myeloid leukemia WITH multilineage dysplasia without prior myelodysplastic syndrome.
The histology code for the case example is 9861/3 [Acute myeloid leukemia, NOS].
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
