Primary Site/Surgery of Other Site--Leukemia: If hairy cell leukemia is diagnosed at splenectomy, and 1 month later a bone marrow confirms the same diagnosis, is the primary site coded to spleen or bone marrow? If the site is bone marrow, is the splenectomy coded to 2 (regional) or 4 (distant) in the surgery field?
For cases diagnosed prior to 1/1/2010:Primary site:
Code the primary site to C421 [bone marrow] per primary site coding instructions for leukemia in the 2007 SEER manual, page 70.
Surgery of other site:
Since all surgical procedures for hematopoietic diseases are coded in the data item Surgery of Other Site, assign code 1 [Nonprimary surgical procedure performed].
For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
Surgery of Primary Site--Breast: How is this field coded when a re-excision follows a prior mastectomy?
Code the most extensive surgery in Surgery of Primary Site. This is a cumulative field. Assign the appropriate code including all surgeries of the primary site performed during the first course of treatment.
The correct code for mastectomy followed by re-excision will depend on the extent of the re-excision. For example, if the re-excision removed muscle, code radical mastectomy.
Surgery of Primary Site--Melanoma: Which surgery codes should be used for cases that have a 1 cm margin? See Discussion.
For a melanoma case the surgery codes in the 30's are to be used when margins are stated to be less than 1 cm. The codes in the 40's are to be used for cases where the margins are greater than 1 cm.
If the margin is exactly 1 cm, assign a surgery code from the 20-36 range. Use a code in the 40's only when the margin is greater than 1 cm.
MP/H Rules--Colon: What histology would you assign to a single tumor with the histology 'well differentiated mucinous cystadenocarcinoma in a villous adenoma confined to the appendix'? Does rule H4 apply to this diagnosis or should we continue on in the rules to H14 and code the higher histology?
For cases diagnosed 2007 or later, use rule H4.
Stop at the first rule that applies to the case. Rule H4 is the first rule that applies.
The polyp rule, H4, comes before many of the other colon rules because it is important to know that the malignancy originated in a polyp.
Race, Ethnicity/Spanish Surname or Origin: Which Spanish Surname List (from 1980 census or 1990 census) would SEER prefer us to use to code 7 in Spanish Surname or Origin? See Discussion.
In the SEER coding manual, it refers to "a list of Hispanic/Spanish names" (5e), but does not specify which one to use. Again, for the Computed Ethnicity field, which Spanish Surname List does SEER prefer us to use?
Determine which list is better suited for your geographic area. If the 1990 list is used, determine the probability cut-off that seems most reasonable for your geographic area.
CS Extension--Brain and CNS: How is CS Extension coded for a malignant meningioma that demonstrates extension into adjacent brain tissue?
For malignant brain tumors, code 60 represents extension into the meninges. Would code 60 be the correct code for extension from a malignant meningioma into brain tissue?
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.Assign CS extension code 60 for malignant meningioma with extension to adjacent brain tissue.
According to the I&R, this section of CS was taken directly from SEER Summary Staging, since AJCC does not have a staging system for these tumors.
CS Extension--Lymphoma: When does the coding change take effect that is referred to in SEER edit IF195, that states localized lymphoma in primary sites C024, C090-099, C111, C142, C172, C181, and C379 must be coded to CS extension 10, and cannot be coded to extension 11? See Discussion.
CS version 1.04 does have a new note 1 in the lymphoma scheme that appears this coding change. In the past, we used code 11 with these sites for localized lymphoma and SINQ 20061088 confirms this line of thinking.
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.
This change was made with the release of CS version 01.04.00 on October 31, 2007. The rules went into effect for cases diagnosed January 1, 2008 and later. A note was added to SINQ 20061088 stating that the answer pertains to cases diagnosed prior to January 1, 2008.
Histology--Breast: What is the histology code for a 2007 diagnosis of basal-type breast carcinoma?
Code basal-type breast carcinoma to 8500/3 [Infiltrating duct carcinoma, NOS].
Basal-type breast carcinoma is a subtype of infiltrating duct carcinoma thought to have a poorer prognosis. There is no specific ICD-O-3 code for basal-type breast carcinoma.
MP/H Rules/Multiple primaries--Lung: Should a subsequent primary be abstracted using rule M8 for a patient diagnosed in January 2000 with adenocarcinoma of the right upper lung if the patient initially sought alternative therapies and presented in September 2007 for a right upper lobe lung mass with extension into the mediastinum, mediastinal lymph node mets and a pericardial effusion? See Discussion.
After more than seven years, the patient in this case decided to proceed with the originally suggested standard therapy. Is this a multiple primary case because the tumors are "diagnosed" more than 3 years apart? Or should we assume this is further progression of the 2000 case because it was originally only treated with alternative therapies? The clinician in this case indicates the patient is being referred for treatment to the right upper lung originally diagnosed in 2000.
For cases diagnosed 2007 or later:
Do not abstract a 2007 primary for this case. From the information provided, there is disease progression/extension and lymph node metastasis in 2007; but there are no new lung tumors in 2007. Therefore, the 2007 MP/H rules do not apply.
An official website of the United States government
Home