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Report Produced: 11/05/2025 22:56 PM

Report Question ID Question Discussion Answer Year
20051066

CS Site Specific Factor--Prostate: Explain the difference among SSF4 prostate codes 150 [No clinical involvement of prostatic apex & prostatectomy apex extension unknown], 510 [Clinical involvement of prostatic apex unknown & No prostatectomy apex extension], and 550 [Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown].

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Site Specific Factor 4 captures the status of clinical apex involvement and prostatectomy apex involvement. The first digit in codes 110-550 indicates the clinical status of apex involvement. The second digit indicates apex involvement found at prostatectomy. The third digit is always zero. For both first and second digits, the codes and definitions are the same:

1 - No involvement of prostatic apex

2 - Into prostatic apex/arising in prostatic apex, NOS

3 - Arising into prostatic apex

4 - Extension into prostatic apex

5 - Apex extension unknown

Code 150 = No clinical involvement of prostatic apex & prostatectomy apex extension unknown

Code 510 = Clinical involvement of prostatic apex unknown & No prostatectomy apex extension

Code 550 = Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown

 2005
20091034 CS Extension--Ovary: How are the following terms coded when they are described in the medical record without any other qualifying information? Seeding, talcum powder appearance, salting, miliary, and studding.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Seeding, talcum powder appearance, salting and studding are synonymous with implants. When the size of implants is not stated, but operative report and scans state "seeding," "talcum powder appearance," "salting," and "studding" the CS extension code choice will depend on the location of the seeding, talcum powder appearance, salting, or studding.

The word "miliary" is not documented as a synonym for implants.

The term miliary does not affect the CS extension code choice according to the current CS instructions.

 2009
20081070

CS Lymph Nodes/CS Mets at DX--Ovary: How are the following lymph node regions/chains coded in the Collaborative Stage schema for ovary?

1. pericolonic

2. pelvic, NOS

3. mesenteric, NOS

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Revised 7-17-09

Assign CS Lymph Nodes code 10 for involvement of pelvic lymph nodes, NOS.

Code involvement of pericolonic nodes or mesenteric nodes, NOS in CS lymph nodes.

 2008
20051102 CS Extension--Breast: What is the CS Extent for this 2004 breast cancer? See Discussion. A patient had lobular carcinoma of the left breast in 2000. At that time, she had bilateral simple mastectomies and the right breast was benign. In 2004, she notices a nodule in the right chest wall, which is excised and found to be invasive ductal ca and lobular ca in situ. So is this Sequence 2, C50.9, 8522/3. And what is the CS Extent - 40 chest wall? (The physician stages this as T2N0M0)

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Residual breast tissue is present following a mastectomy. If the nodule is in the breast tissue (tissue above the ribs), assign CS extension code 10 [Confined to breast tissue...Localized, NOS]. If the nodule is in the chest wall (tissue below the ribs), assign code 40 [Invasion of chest wall].

 2005
20041064 CS Tumor Size/CS Extension/CS TS/Ext-Eval--Breast: How do you code these fields when the tumor size and extension differ pre and post treatment with neoadjuvant Arimidex? See Discussion. Clinically on PE 3 cm mass attached to skin with dimpling and erythema overlying the mass. Ultrasound: 2-3 cm breast mass with overlying skin thickened by US evaluation, suggesting dermal invasion. Neoadjuvant Arimidex followed by MRM. Path: 4.5 cm ductal carcinoma (no DCIS), no invasion of skin.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Record the larger tumor size and the farthest extension documented.

Code CS Tumor Size/Extension Evaluation to 6 [Surgical resection performed, WITH pre-surgical systemic treatment...; tumor size/extension based on pathologic evidence].

Code CS Tumor Size for the example to 045 [4.5 cm].

Code CS Extension to 20 [Local skin involvement ...] based on clinical description provided.

 2004
20071081 CS Site Specific Factor--Lymphoma: Can the registrar calculate the International Prognostic Index (IPI) score from information found in the H&P or on the back of a TNM form for the SSF 3 field if the physician does not document it in the medical record?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Record the IPI score in SSF3 when the score is documented in the medical record. If the score is not stated, do not calculate it.

 2007
20061005 CS Reg LN Pos/Exam: Are lymph nodes coded as positive or negative when the pathology report for a lymph node dissection performed after radiation and chemo reveals that the nodes are negative but they demonstrated previous involvement by cancer? See Discussion. Scenario: The patient was treated with radiation and chemotherapy prior to resection for esophageal cancer. The pathology report stated, "1/3 nodes c/w treated previous ca."

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Record lymph nodes that are pathologically confirmed as positive in Regional Nodes Positive. Evidence of previous involvement by cancer is not recorded in this data item.

In the above scenario, the lymph nodes are negative according to pathology.

Clinically positive lymph nodes are coded in CS Lymph Nodes.

 2006
20091041

CS Lymph Nodes--Ovary: Are positive lymph nodes removed from "colon tissue" during a modified posterior pelvic debulking regional or distant? If regional, what is the appropriate CS LN code?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Pericolonic lymph nodes are "regional" lymph nodes for an ovarian primary. If you do not have enough information to assign codes 12-30, assign code 50 [Regional lymph nodes, NOS].

 2009
20091107

CS Extension--Lymphoma: Does peripheral blood involvement affect the stage for lymphoma? See Discussion.

2009 Diagnostic Year

Lymph node bx is positive for Mantle Cell lymphoma. Flow cytometry on lymph node tissue shows CD+ pos B cell lymphoproliferative disorder. IHC findings support Mantle Cell lymphoma. Flow cytometry on peripheral blood shows CD+ B cell lymphoproliferative disorder. Because the lymph node is positive for Mantle Cell lymphoma and the flow cytometry findings are the same on the lymph node tissue and peripheral blood, is the peripheral blood involved (Stage IV disease)?

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.No. Peripheral blood is not the same as bone marrow involvement which is what would be required for stage IV.

Lymphomas can arise in lymph nodes which are connected by lymphatic vessels. Both lymphatic vessels and blood vessels travel through lymph nodes and malignant cells can travel between the vessels. Cells in peripheral blood do not prove Stage IV.

 2009
20041046

CS Tumor Size--Breast: When the diagnosis is inflammatory carcinoma of the breast, must the CS tumor size always be 998? See Discussion.

I have no specific example of a situation; I am writing an edit check and wondering if there would be any exceptions to this rule.

This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.No. For inflammatory carcinoma, code the size of the tumor in CS tumor size. Use code 998 [diffuse] when the tumor is stated to be "diffuse."

Page 27 in Part I of the CS manual will be corrected to define code 998 for breast as only "diffuse." The errata should be distributed in July 2004.

 2004