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SEER Inquiry System - Report
Produced: 12/26/2024 6:41 PM
Question 20190080
Inquiry Details
References:
Standard setters agreement
Question:
Update to current manual/Surgery of Primary Site/Surgery codes--Melanoma: Can the operative report be used to assess margins if there is no residual melanoma on the wide excision and no margins stated, or if distance is not stated on the pathology report when there is residual melanoma? See Discussion.
Discussion:
1) Is the operative report only used for margins when the wide excision states no residual disease and no margins are stated on path report? Or do you use the operative report too for margins when the wide excision has residual melanoma and margins are negative but distance is not stated on path report? Does it matter if there was residual melanoma on the wide excision or not as far as using the operative report for margins?
2) Do these rules only apply to melanoma cases or do they also apply to Merkel cell?
3) Did CoC and SEER both agree on this? Are they going to send out an update because this is not how I interpret what is in the STORE manual/SEER manual under the surgery codes. It might be good to send out an official update to the surgical coding rules if this is how we are to code now.
Answer:
1. You may take margin information from the operative report if it is missing from the pathology report when assigning the surgery codes for skin.
- Exception: Do not apply this to surgery codes 45-47 where specific instructions about microscopic confirmation are included
2. The rule applies to any skin malignancy for which the skin surgery codes apply.
3. SEER, CoC, NPCR, NCRA, NAACCR, and the Canadian registries participated in this decision. SEER is publishing this SINQ question for reference.
