An official website of the United States government
Government Funding Lapse
Because of a lapse in government funding, the information on this website may not be up to date, transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted. The NIH Clinical Center (the research hospital of NIH) is open. For more details about its operating status, please visit cc.nih.gov. Updates regarding government operating status and resumption of normal operations can be found at OPM.gov.
CS Lymph Nodes: Are lymphatic channels/vessels within an organ coded as regional lymph nodes?
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.Lymphatic channels/vessels carry lymph fluid throughout the organs and tissues of the body. Lymph channels/vessels within an organ are not nodes. Lymph channels/vessels outside an organ are not nodes.
Surgery of Primary Site--Skin: What surgery code is used to reflect the amputation of a finger for subungual melanoma?
47 [Wide excision or reexcision of lesion or minor (local) amputation with margins greater than 2cm] is the correct surgery code for amputation of a finger for melanoma.
Reportability--Lung: One of our facilities has a case they are not really sure how to report.
This patient came in for a double lung transplant due to COPD which occurred on 1/27/14. At time of transplant, the team found out the donor hospital had identified a small nodule in the right lower lobe donor lung, which they biopsied and deemed negative. However, the slides were reviewed and felt to represent adenocarcinoma. The team performed a right lower lobe lobectomy of the donor lung before transplanting into the patient.
So, we are not really sure how to handle this case. The adenocarcinoma actually belongs to the donor patient from another hospital, however, they actually didn’t identify it at that facility as their pathology was negative for a malignancy.
This very interesting case is not reportable to either facility. Since the right lower lobe nodule was resected prior to transplantation, the case does not belong to your patient. Ideally, the cancer should be assigned to the donor; however, donor information is confidential.
Reportability--Colon: Would a carcinoid tumor, NOS, of the appendix with perineural or angiolymphatic invasion be reportable if there is no mention of malignancy in the pathology report?
Carcinoid, NOS, of the appendix diagnosed in 2015 or later is reportable.
For cases diagnosed prior to 2015
Carcinoids of the appendix are reportable when they meet any of the following conditions.
The pathologist designates the carcinoid as malignant
Regional lymph nodes are positive for MALIGNANT carcinoid (not reportable if lymph nodes are reported to be involved with benign carcinoid disease)
There are discontinuous metastatic implants or involvement
Note that the implants/involvement must be designated as malignant. Many benign tumors will spawn implants that are also benign. If implants are benign, this is not a reportable tumor.
Surgery of Primary Site--Ovary: How should this field be coded for an ovarian primary when there is a BSO and only the fundus of uterus is removed (not a full hysterectomy)?
Assign surgery code 52 [Bilateral (salpingo-) oophorectomy; WITH hysterectomy]. Code 52 does not exclude a partial hysterectomy.
Terminology/Terms of involvement: When the terms "lytic" or "lysis" are used in an imaging study, are they to be interpreted as synonymous with metastasis, or can these terms be used to describe a non-malignant condition?
Although the term "lytic lesion" is often used to describe bone lesions and "tumor lysis" develops in response to systemic therapy, the words are not a part of the SEER list of terms used to describe involvement. Do not code distant metastasis based only on these words.
Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Brain and CNS: How many primaries should be abstracted and should the histology field(s) be coded to 9530/1 [Meningiomatosis, NOS] or 9530/0 [Meningioma, NOS] to represent a case that presents with MRI confirmed multiple meningiomas (e.g., left dura, right parasagittal region, and left frontal lobe)?
For tumors diagnosed prior to 2007:
Abstract this case as two primaries, right and left cerebral meninges. Code the histology for both primaries to 9530/0 [Meningioma, NOS]. Use code 9530/1 [Meningiomatosis, NOS] only when the diagnosis is stated to be meningiomatosis, or multiple meningiomas.
For tumors diagnosed 2007 or later, refer to the MP/H rules. If there are still questions about how this type of tumor should be coded, submit a new question to SINQ and include the difficulties you are encountering in applying the MP/H rules.
Reportability--Heme & Lymphoid Neoplasms: According to the hematopoietic database, systemic mastocytosis is reportable; does that include INDOLENT systemic mastocytosis (which is not listed in the list of alternative names)?
For cases diagnosed 2018 and forward, indolent systemic mastocytosis is not reportable (9741/1). Smoldering systemic mastocytosis is reportable (9741/3).
Measured Thickness/EOD-Extension--Melanoma: If the Clark's level is not provided, can it be estimated using the depth of invasion provided in the pathology report and associating that number with the Clark's levels identified in the SEER Summary Staging Guide?
For cases diagnosed 1998-2003:
No. Do not use the SEER Summary Stage Guide or any other guide to derive an estimated Clark's level from the thickness identified in the pathology report. The two measurements need to come directly from the pathology report. Each is coded separately in EOD. Thickness is collected in a separate field so we can capture the actual measurement stated in the pathology report. This has made it possible for us to group depth of invasion for analysis purposes in any manner we might wish. In addition, we can always collapse this information to the Summary Stage or TNM using the AJCC rules. AJCC rules use both depth of invasion and thickness in determining pathologic staging, and, if there is an inconsistency between them, the rules say code to the higher T classification, that is, the least favorable finding.
Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are reported if a 2013 diagnosis of right leg skin nodules, consistent with plasmacytoma/plasma cell myeloma, follows a 3/20/07 biopsy diagnosis of multiple myeloma?
Abstract this case as a single primary. Code the histology to 9732/2 [multiple myeloma].
Review the Abstractor Notes section in the Heme DB for multiple myeloma. It states that in multiple myeloma there is generalized bone marrow involvement and that extramedullary involvement is diagnostic of advanced disease. This is a case of advanced multiple myeloma.
An official website of the United States government
Home
