Primary Site--Ovary/Peritoneum: Should this field be coded to ovary or peritoneum when the bulk of the tumor is in the peritoneum and there is only surface involvement of the ovary?
If it is not clear where the tumor originated, use the following criteria to distinguish ovarian primaries from peritoneal primaries.
The primary site is probably ovarian, unless:
--Ovaries have been previously removed
--Ovaries are not involved (negative)
--Ovaries have no area of involvement greater than 5mm.
Descriptions such as "bulky mass," "omental caking" probably indicate an ovarian primary.
Descriptions such as "seeding," "studding," "salting" probably indicate a peritoneal primary.
Reportability--Bladder: Is "low grade papillary urothelial neoplasm with no evidence of invasion" reportable to SEER?
"Neoplasm" means "new growth," not malignancy. A low grade papillary urothelial NEOPLASM with no evidence of invasion [8130/1] is not reportable to SEER. However, a low grade papillary urothelial CARCINOMA with no evidence of invasion [8130/2] is reportable.
Histology (Pre-2007)--Colon: Must a case be specifically labeled "familial adenomatous polyposis" or is the mere presence of numerous/multiple polyps sufficient for coding the histology to FAP?
For tumors diagnosed prior to 2007:
The presence of numerous/multiple polyps is not necessarily adenomatous polyposis coli. Adenomatous polyposis is an extreme condition usually characterized by the presence of hundreds of polyps and should be identified as such either clinically or pathologically.
Look for the term "Familial adenomatous polyposis," FAP or one of its synonyms:
Adenomatosis of the colon and rectum [ACR]
Familial adenomatous colon polyposis
Familial colonic polyposis
Multiple familial polyposis
In the absence of these terms, the following probably indicate a diagnosis of FAP:
Hundreds of adenomatous polyps throughout large intestines, and at times, throughout the digestive system
Development of polyps as early as ten years of age, but more commonly at puberty
History of colectomy
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.
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.
Date Therapy Initiated/First-Course of Cancer-Directed Therapy Fields/Summary Stage 2000--Prostate: How do you code these fields for a case that received preventative chemo before a definitive cancer diagnosis?
A patient has a "suspicious but not diagnostic" biopsy of the prostate in 09/2002. Doctor said it was not cancer and put the patient on a preventative chemo drug study (GTX-211). The patient returned for a repeat biopsy on 04/2003. Biopsy returned positive for adenocarcinoma. The patient had not been diagnosed when chemo was administered. Can the case be staged using the post-chemo information?
Stage this case the same as all other cases. Use only the information subsequent to the date of diagnosis to code stage and treatment.
The diagnosis date in the example is 04/2003. Do not use information prior to 04/2003 to code stage or treatment. Do not code the preventative chemo as treatment.
Histology (Pre-2007): Can we ever code this field using a more specific cell type from a metastatic site specimen rather than to a less specific cell type from the primary site specimen? See Discussion.
The histology for a metastatic deposit biopsy is mucin-producing adenocarcinoma. This report states that the primary site is the stomach. It is more specific than the histology from the stomach biopsy described as adenocarcinoma, NOS.
For tumors diagnosed prior to 2007:
Code the histology for the case example to 8481/3 [mucin-producing adenocarcinoma], the more specific histology.
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.
Histology (Pre-2007)--Lung: What is the correct histology code for this case of squamous cell carcinoma with several different variants? See Discussion.
The path report from a left pneumonectomy says: This squamous cell carcinoma had several different variants present including typical non-keratinizing squamous cell, spindled cell squamous cell, clear cell squamous cell and a small cell variant of squamous cell.
I cannot find a combination code that fits; the majority of the tumor is not stated; so do you code the highest specific type mentioned - 8084 - Squamous cell, clear cell type?
For tumors diagnosed prior to 2007:
Assign histology code 8070 [squamous cell carcinoma, NOS]. Squamous cell carcinoma, NOS includes types of squamous cell carcinoma without a specific code. This is a combination squamous tumor that does not have a unique code.
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.
CS Lymph Nodes/CS Reg Nodes Eval -- Rectum: If the rectal tumor is not treated with a resection but on endoscopic ultrasound the patient is stated to have a lymph node above the primary tumor and the physician stages the case clinically as N1, should the CS Lymph Nodes field be coded to 30 [Regional lymph node(s), NOS] or 10[Rectal, NOS]? Should the evaluation field be coded to 0 [No lymph nodes removed. Evidence based on other non-invasive clinical evidence] or 1 [No lymph nodes removed. Evidence based on endoscopic examination.]? See Discussion.
Rectal primary:
5/04 sigmoidoscopy w/bx of rectal mass: adenocarcinoma. 6/04 Endoscopic ultrasound of rectal mass: invasion through wall but no definite invasion of prostate or seminal vesicles; 7.5mm lymph node located above tumor, no other enlarged lymph nodes detected. Patient did not have surgery. Physician staged lymph node involvement to clinical N1.
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 Lymph Nodes code 10 [Regional lymph nodes] based on the physician's N1. Assign code 10 because it is the lowest numerical CS code that corresponds to N1 in the scheme for rectum. Use the physician's assignment of TNM when the information in the medical record is incomplete or ambiguous. Code CS Reg Nodes Eval field 0 [No lymph nodes removed] for the case described above because there is no indication that N1 was assigned based on the endoscopic exam. The NI may be based solely on TNM documentation provided by the clinician and you do not know what the clinician used as the basis for the staging.
An official website of the United States government
Home