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Surgery of primary site--Lung: Should microwave ablation be coded as treatment for lung cancer, and if so, how should it be coded?
Code microwave tumor ablation as surgery. For lung, assign code 15.
This question was discussed by the technical advisory group – a small group of representatives from each standard setter which meets periodically. The group agreed on this consensus answer.
Reportability/AmbiguousTerminology: Because there is a caveat in the SEER PCM, 3rd edition to ignore adverbs such as "strongly" when assessing reportability, should a term such as "likely" cancerous be reportable given than the expression "most likely" cancerous is reportable?
"Likely cancerous" is NOT reportable.
The CoC, NPCR and SEER have agreed to a strict interpretation of the ambiguous terms list. Terms that do not appear on the list are not diagnostic of cancer.
EOD-Extension--Head & Neck (Uvula): Is a stage T2 tumor described on the physical exam as an "ulcerated mass occupying uvula midline soft palate, and extending into the right soft palate. It does not extend into the tonsil area nor into the retromolar trigone" coded to 30 [localized, NOS] or 40 [tumor crosses midline]?
For cases diagnosed 1998-2003:
Code EOD-extension to 30 [localized, NOS]. This is mucosal spread (since there is no muscle in the uvula). Soft palate and uvula are handled as a single site, and extension from uvula to soft palate is not addressed in EOD.
Reportability--Skin: Is a pilomatrix carcinoma of the skin reportable if it is described as being a malignant diagnosis based on poor circumscription, infiltrative growth pattern, and focal abundant mitoses?
No. Pilomatrix carcinoma is not reportable to SEER. Please see page 1 of the 2004 SEER manual. Skin primaries with histology codes from 8090 to 8110 are not reportable. Pilomatrix carcinoma is coded 8110/3.
Other Therapy/Immunotherapy--Hematopoietic, NOS: How should erythropoietin be coded for leukemia or other hematopoietic diseases?
Do not code Erythropoietin as treatment, it is used as an ancillary drug for leukemias or other hematopoietic diseases. Record information about erythropoietin in the text field.
MP/H Rules/Histology--Colon: When the microscopic description indicates a colon tumor is "tubulovillous," but the final diagnosis only states "adenocarcinoma," is the histology coded to 8263/3 [adenocarcinoma in a tubulovillous adenoma]?
For cases diagnosed 2007 or later:
Yes. This is an example of a site-specific exception to the general rule to code only from the final diagnosis. The Colon Histology Rules specifically state that "other parts of the pathology report" may be used to identify a tumor arising from a polyp, adenomatous polyp, villous adenoma, or tubulovillous adenoma.
Update to Current Manual/Neoadjuvant Treatment: What codes should be used for Neoadjuvant Therapy--Clinical Response and Neoadjuvant Therapy--Treatment Effect when the neoadjuvant therapy is still in progress at the time the case is initially abstracted as with rapid reporting. There is no code for neoadjuvant therapy still in progress and code 9 generates an edit for Neoadjuvant Therapy--Clinical Response.
Assign code 8 for Neoadjuvant Therapy--Clinical Response and assign a code 9 for Neoadjuvant Therapy--Treatment Effect when the treatment is still in progress. Revise these codes after the treatment has been completed.
We will update the manual to include these instructions.
Surgery of Primary Site/Surgical Procedure of Other Site--Bladder: What codes are used to represent these fields for a deeply invasive bladder primary treated initially with a TURP (for suspected prostate extension that turns out to be pathologically negative) and a TURB that is subsequently treated with a cystoprostatectomy?
For cases diagnosed 1/1/2003 and after, code:
1. Surgery of Primary Site field to 60 [Radical cystectomy (male only)] because the cystoprostatectomy was the most extensive (definitive) surgery performed to the primary site.
2. Surgical Procedure of Other Site to 2 [Non-primary surgical procedure to other regional sites] based on the TURP.
CS Tumor Size--Bladder: Is tumor size coded to 080 when the bladder mass is described as "greater than 8 cm in diameter"?
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.Based on the information provided above, code CS tumor size 080 [8 cm]. Code the information that is avaliable. Since size of tumor is not used to stage bladder cancer, an approximation is adequate.
SEER*RSA/Required data items--Melanoma: The site-specific data item, Ulceration, states it is required by "All" in SEER*RSA but in the NAACCR Data Dictionary table it states is it required by SEER, Commission on Cancer (CoC), and Canadian Cancer Registry (CCCR), not the National Program of Cancer Registries (NPCR). Does the definition of "All" in SEER*RSA not include NPCR? Also, please explain the difference between Required by: "All" and "Required by CCCR/Canada, COC, NPCR, SEER" (all listed out).
Use the NAACCR Data Dictionary Required Status Table or refer to standard setter requirements. Do not use SEER*RSA to determine which data items are required to be collected or transmitted. Though "All" in SEER*RSA generally refers to the standard setters including CoC, NPCR, CCCR, and SEER, some items in SEER*RSA need updating; this is planned for 2022.
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