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SEER Inquiry System - Report
Produced: 11/25/2024 7:46 AM
Question 20120030
Inquiry Details
References:
2007 MP/H Rules
Question:
MP/H Rules/Histology- -Melanoma: What is the correct histology code if the final diagnosis for an excisional biopsy specimen is reported as "malignant melanoma, superficial spreading type" but the under the "cell type" section in the CAP protocol layout of the pathology report it lists "cell type: epithelioid"? See Discussion.
Discussion:
The MP/H rules do not address the concept of "cell type" for melanomas when the pathologist uses the CAP protocol to report findings and the cell type listed in that section of the report differs from the specific cell type mentioned in the final diagnosis. Does a case have two specific cell types when the final diagnosis and the "cell type" sections of a single pathology report indicate two more specific melanoma histologies?
Pre-2007 SINQ entries indicate the cell type should be coded. However, if it differs from the specific cell type listed in the final diagnosis does it matter? Do the MP/H rules still take the cell type into account?
Answer:
Code the histology to malignant melanoma, superficial spreading type [8743/3] based on the final diagnosis. For cases diagnosed 2007 or later, the steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules manual. For a melanoma primary, use the Melanoma Histology rules to determine the histology code because there are site specific rules for cutaneous melanomas.
Start at Rule H1. The rules are intended to be reviewed in consecutive order from Rule H1 to Rule H10. The rules are intended to be reviewed in consecutive order within the applicable Module. Code the more specific histologic term when the diagnosis is melanoma, NOS [8720] with a single specific type (i.e., superficial spreading) mentioned in the final diagnosis.
The final diagnosis takes precedence over the CAP protocol. The CAP protocol may be used when it provides additional or noncontradictory information, but that does not apply in this case.
