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Report Produced: 04/25/2026 12:43 PM

Report Question ID Question Discussion Answer Year
20041007 Other Cancer-Directed Therapy--Hematopoietic, NOS: How is this field coded when transfusions are used to treat acute leukemia or thrombocythemia? Transfusions are NOT recorded as treatment for acute leukemia or thrombocythemia. . 2004
20041042 Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Kidney: How many primaries, with what histology(ies) should be coded when nephrectomy pathology specimen shows separate tumors of "renal cell carcinoma [clear cell type]" and "renal cell carcinoma [granular cell type]"?

For tumors diagnosed prior to 2007:

Abstract two primaries. This is an example of two tumors with different histologic types in the same site. The right kidney has two separate tumors.

8310/3 [renal cell carcinoma (clear cell type)]

8320/3 [renal cell carcinoma (granular cell type)]

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.

 2004
20041005 EOD-Extension--Retroperitoneum: Does the presence of "necrotic masses, NOS" in the blood, which are not pathologically evaluated, affect the coding of this field? See Description. Encapsulated malignant tumor within the retroperitoneum was removed. Surgical report: "In the abdomen, blood had necrotic masses floating freely and encapsulated a 3-4" mass." No pathologic assessment of the necrotic masses is available. For cases diagnosed 1998-2003: Necrotic masses do not affect the EOD-extension code. 2004
20041067 Histology (Pre-2007)--Lung: Does 8070 [squamous cell carcinoma], 8560 [adenosquamous carcinoma] or 8255 [adenocarcinoma with mixed subtypes] best represent this field for a lung biopsy described as a "poorly differentiated non-small cell carcinoma with squamous and glandular features with focal mucin positivity per mucin stain"?

For tumors diagnosed prior to 2007:

Assign code 8560/33 [Adenosquamous carcinoma, poorly differentiated]. "Glandular" carcinoma is a synonym for adenocarcinoma. Mixed adenocarcinoma and squamous carcinoma is coded to 8560. Do not use code 8255 [Adenocarcinoma with mixed subtypes] when a more specific complex code is available.

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.

 2004
20041074 Histology (Pre-2007)--Colon: Is the histology coded as adenocarcinoma arising in a polyp when the final diagnosis on the pathology report is adenocarcinoma but the colonoscopy report associated with the path states that the surgeon performed a polypectomy? See Discussion. Histology: 3/04 Colonoscopy with polypectomy of a sessile appearing polyp. Path report: Final Dx: Adenocarcinoma; Micro: Adenocarcinoma apparently arising from the mucosa...noted to invade the muscularis mucosa into the submucosa.

For tumors diagnosed prior to 2007

Code this case to adenocarcinoma [8140]. The best source for histology is the final diagnosis on the path report from the procedure that removed the most tumor tissue. When there is a conflict, the path diagnosis has higher priority than the colonoscopy diagnosis for coding 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.

 2004
20041001

Histology (Pre-2007)--Pancreas: Should pancreatic neoplasia III (PanIN III) be coded to 8010/2 [carcinoma in situ, NOS] or 8500/2 [Ductal carcinoma in situ]? See Description.

There is no specific morphology code for PanIN-III in the ICD-O-3. In the chapter for exocrine pancreas found in the sixth edition of AJCC cancer staging manual, pg 160, reference is made to PanIN-III and its inclusion with carcinoma in situ.

For tumors diagnosed prior to 2007:

Code PanIN-III (pancreatic intraepithelial neoplasia III) as 8500/2 [Ductal carcinoma in situ, includes DIN 3: Ductal intraepithelial neoplasia 3]. PanIN-III is a synonym for carcinoma in situ according to the WHO classification of Tumors and the College of American Pathologists' Protocol for exocrine pancreas. Do not code PanIN-I or PanIN-II as cancer.

For tumors diagnosed 2007 or later, see SINQ 20110081 and 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.

2004
20041076 CS Extension--Colon: What is the difference between codes 46 [Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)] and 57 [Adherent to other organs or structures, NOS]? See Discussion.

Code 46 reads "Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)".

Would these examples be coded to 46?

Example 1: 7/04 Op findings: mass was adherent to duodenum without obvious invasion. Path: margins negative (no mention of duodenum). Case staged to pT3.

Example 2: Op findings: large mass involving cecum adherent to peritoneum & retroperitoneum. Path: invasion of pericolic soft tissue; margins negative (no metion of peritoneum & retroperitoneum). Case staged to pT3.

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.

Code 46: Attached to other organ (on imaging or surgical observation); pathology says no invasion of the other organ. Code 57: Attached to other organ; pathology is positive for invasion of other organ, or pathology does not specify whether there is invasion of the other organ.

Example 1: Code extension to 46 [Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)]. The tumor was attached to the duodenum, but not invading

Example 2: Code extension to 46 [Adherent to other organs or structure, but no microscopic tumor found in adhesion(s)]. The tumor was attached to peritoneum & retroperitoneum, but not invading based on negative margins and no peritoneum or retroperitoneum specimen submitted to pathologist.

 2004
20041039 Multiple Primaries (Pre-2007)--Kidney/Bladder/Renal Pelvis: Would transitional cell carcinoma of the left renal pelvis, diagnosed two years after a diagnosis of invasive bladder cancer, be a second primary when the discharge is "recurrent transitional cell carcinoma, left kidney"?

For tumors diagnosed prior to 2007:

This is an example of the term "recurrent" being used loosely to refer to another primary in the urinary tract. It is highly unlikely that a bladder tumor would metastasize to the kidney. Much more likely is the field defect or regional breakdown of the urothelial tissue that lines the tract from the renal pelvis to the urethra. Furthermore, bladder tumors don't spread retrograde to the kidney. Code as two primaries.

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.

 2004
20041086 Histology (Pre-2007)/CS Tumor Size/CS Extension--Colon: How are these fields coded if a 3 cm sessile polyp is snared and removed piecemeal during a colonoscopy and the path microscopic description indicates a polypoid lesion with foci of malignant transformation found associated with bundles of smooth muscles followed by a LAR with no residual invasive tumor but the final path diagnosis is stated to be a M.D. adenocarcinoma? See Discussion.

3/04 colonoscopy 3cm sessile polyp snared & removed piecemeal. Path Micro: Polypoid lesion consists of branching & complex neoplastic glands lined by tall columnar epithelial...These foci of malignant transformation are assoicated with large polygonal epithelial...associated with desmoplastic stromal reaction & neoplastic glands can be found associated with bundles of smooth muscle.

4/04 LAR: focus of residual HG dysplasia: no residual invasive tumor. Final path dx: MD adenocarcinoma. Physician staged: T2 N0 M0.

Histology: 8140 vs 8210

Tumor Size: 030 vs 999 vs 990

Extension: 12 vs 20

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.

For tumors diagnosed prior to 2007:

Based only on information provided:

Histology: 8210 [Adenocarcinoma in a polyp]

Tumor Size: 999 [Unknown]

CS Extension: 20 [Muscularis propria invaded]

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.

 2004
20041049 Histology (Pre-2007): What code is best used to represent a diagnosis of "metaplastic carcinoma, matrix producing type." The tumor shows poorly differentiated infiltrating duct carcinoma and myxoid, cartilaginous stroma.

For tumors diagnosed prior to 2007:

Code the histology to 8575 [metaplastic carcinoma, NOS]. According to the WHO Classification of Tumors of the Breast and Female Genital Organs, metaplastic carcinoma is a type of epithelial breast tumor. Matrix producing carcinoma is a synonym of metaplastic carcinoma. ICD-O-3 does not have a code for matrix producing carcinoma.

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.

 2004