"Question ID","Question","Discussion","Answer","Year" "20220035","

 

Solid Tumor Rules/Histology--Bladder:  How is histology coded for a transurethral resection of the bladder (TURB) diagnosis with multiple components?  See Discussion.

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Examples:

Bladder TURB:  Invasive high grade urothelial carcinoma with poorly differentiated (40%), lipoid (5%), and sarcomatoid (55%) components.

Bladder tumor base TURB:  Invasive high grade urothelial carcinoma with poorly differentiated (65%) and sarcomatoid (30%) components.

The Urinary Sites Solid Tumor Rules, histology coding rules, say to code the most specific histology or subtype/variant, regardless of whether it is described as majority, minority, or component.  Poorly differentiated (8020) and sarcomatoid (8122) are both urothelial subtypes, but there is no rule to instruct how to code a tumor/tumors with multiple urothelial subtypes.

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Code histology as 8120/3 in the two examples using Note 1 in the Urinary Sites Solid Tumor Rules, instruction 1 of the Coding Histology section.  The subtypes/variants or components must describe a carcinoma or sarcoma in order to code a histology described by those terms.

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