| Report | Question ID | Question | Discussion | Answer | Year |
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20021144 | EOD-Extension--Colon: What code is used to represent this field for a mid-ascending colon primary that invades through muscularis propria and into subserosal fibroadipose tissue that also presents with a "separate serosal nodule" of carcinoma within cecum that is consistent with a tumor implant (cT3, N0, M1)? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 85 [Metastasis], because the nodule of carcinoma in the cecum is not contiguous with the mid-ascending primary colon tumor. |
2002 | |
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20021092 | Histology/Primary Site--CLL/SLL: How should these fields be coded for a "chronic lymphocytic leukemia/small lymphocytic lymphoma" [CLL/SLL] diagnosed on a lymph node biopsy that is referred to by the clinician as CLL? See discussion. | Does the clinician's reference to this disease as CLL change the SEER rule to code to SLL if the disease arises in a lymph node or solid tissue? | For cases diagnosed prior to 1/1/2010:Code the Histology field to 9670/3 [Malignant lymphoma, small lymphocytic, NOS] and the Primary Site field to C77._ [lymph nodes] when CLL/SLL is diagnosed in lymph node or solid tissue, even if the clinician refers to CLL. When CLL/SLL is diagnosed in the blood, code as leukemia.
Refer to clarification #6 on the ICD-O-3 Errata and Clarifications. "...if disease is diagnosed only in the blood or bone marrow, code the primary site to C42.1, bone marrow and assign the leukemia morphology code. If the diagnosis is made on any other tissue (typically lymph nodes, lymphatic structures, breast, and stomach), code to the tissue involved and assign the lymphoma morphology. If the diagnosis is made on both blood or bone marrow and a tissue biopsy, code the tissue involved and assign the lymphoma morphology." For cases diagnosed 2010 forward, 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. |
2002 |
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20020030 | EOD-Size of Primary Tumor: 1) Can we add "Imaging studies" to those EOD schemes that currently do not include this on their priority list for coding size? 2) When an EOD scheme already lists specific types of imaging studies, are we limited to only those types of procedures or can any imaging study be used to code size? See discussion. | How do we determine where to add "imaging studies" to the priority listing? Currently the hierarchy differs for primaries that currently include imaging studies on their EOD schemes. For example, on the breast EOD imaging ranks lower than the physical exam while on the thyroid EOD imaging ranks higher than the physical exam. | For cases diagnosed 1998-2003:
1) You may add "Imaging" to the size priority list for all EOD schemes that currently do not include it. Prioritize it just above the physical exam for these sites.
2) You may use the information from any imaging technique to code tumor size, even for those sites such as breast and bladder where specific imaging tests are mentioned. |
2002 |
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20021207 | EOD-Lymph Nodes--Breast: How do you code this field when the gross description on the pathology report states "nodal tissue is matted" but only 1/18 lymph nodes is found to contain micrometastatsis per the microscopic description of the report? | For cases diagnosed 1998-2003:
Code the EOD-Lymph Nodes field to 1 [Micrometastasis] because the matted nodal tissue was found to contain only one node with micrometastasis when examined microscopically. Coding priority is given to the microscopic description over the gross description. |
2002 | |
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20021206 | EOD-Extension--Breast: The SEER coding scheme classifies the in situ portion as less than 25% [code 14] or equal to or greater than 25% [code 15]. How do you code a pathologist's statement of "less than or equal to 25%"? See discussion. | "insitu ca constitutes less than or equal to 25% of the total mass." | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 14 [invasive and in situ components present, size of entire tumor coded in Tumor Size AND in situ described as minimal (less than 25%)]. The pathologist did not use a code as defined by SEER. For cases described as "less than or equal to 25%", choose the lower of the two EOD code choices. |
2002 |
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20021181 | Radiation/Chemotherapy: How do we code radiation and chemotherapy when the only statement we have is that the patient is "referred to either an oncologist or a radiation therapist"? | For cases diagnosed 1/1/2003 and after: A referral does not mean that the radiation therapy or chemotherapy was actually recommended. These cases need follow-back to see if treatment was recommended and/or administered. Some registries code these cases as 8 [Radiation recommended, unknown if administered] or 88 [Chemotherapy recommended, unknown if it was administered] and routinely review all cases with 8 or 88 codes. Upon review, the codes are updated depending on the information found. If there is no information available, the code 8 or 88 is changed to 0 or 00 [None]. | 2002 | |
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20021082 | Multiple Primaries (Pre-2007)/Primary site/EOD-Extension--Head & Neck: How many primaries are represented by an invasive squamous cell carcinoma of the floor of mouth with in situ squamous cell carcinoma involvement of the frenulum? |
For tumors diagnosed prior to 2007: Code the Primary Site field to C04.9 [floor of mouth]. Because the cancer did not INVADE into a neighboring site (through wall, through soft tissue), it just spread along the mucosa (in situ) to involve the frenulum, this is one primary. For cases diagnosed 1998-2003, in situ extension via mucosal spread to the frenulum is ignored for purposes of coding EOD-Extension. 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. |
2002 | |
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20021126 | EOD-Extension--Head & Neck (Tonsil): How should the EOD-Extension field be coded for bilateral tonsil involvement? See discussion. | Tonsillectomy and bilateral radical neck dissections were done. The path diagnosis was left and right tonsils: squamous cell carcinoma, bilateral tonsils with negative inked surgical margins of resection. Physical exam and operative findings did not mention any extension beyond the tonsils. We originally coded the EOD-Extension field to 30 for a bilateral tonsil primary. The case failed the SEER Edit IF41 (Primary Site/Lat/EOD). According to that edit, if laterality is 4 then the EOD-Extension field must not be 00 through 30. We recoded the EOD-Extension field to 99 in order to comply with the SEER edit. |
For cases diagnosed 1998-2003:
Code EOD extension as 30 [Localized, NOS] and laterality as 4 [Bilateral involvement]. The next update to the SEER edits will allow this combination. |
2002 |
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20021124 | Multiple Primaries (Pre-2007)/Primary Site/EOD-Extension--Lung: Should lung cases be counted as more than one primary when nodules removed from separate lobes of the same lung have either the same histology or they are different immunophenotypes of the same main histologic classification (e.g., adenocarcinoma)? See discussion. |
1. Path report: "Two nodules (RLL, RUL) of primary pulmonary demonstrate adenocarcinoma with different histologic appearances and different immunophenotypes consistent with synchronous lung adenocarcinomas." Per ICC interpretation, two lung primaries are favored. 2. Path report: "Two peripheral nodules (LLL, LUL) demonstrate similar P.D. non-small cell carcinoma with features of large cell undifferentiated carcinoma." |
For tumors diagnosed prior to 2007: According to current SEER rules, both examples represent one primary because both tumors are in one lung and of a single histologic type. Code the Primary Site field to C34.9 [Lung, NOS] for both examples and the EOD-Extension field to 77 [Separate tumor nodules in different lobe]. This will capture the fact that there are multiple tumors within the lung for each of these examples. Differences in immunophenotypes confirm independent de novo cancers and rule out metastasis. Immunophenotype differences do not equate to different histologies. In the first example described, there are different histologic features; however, the main classification is adenocarcinoma. 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. |
2002 |
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20020018 | EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Cervix: What codes are used to represent these fields for a cervix primary when the only information on lymph nodes is a CT of the pelvis showing "pelvic adenopathy" (no surgery was done)? | Code the EOD-Lymph Nodes field to 9 [unknown]. Code the Pathologic Review of Number of Regional Lymph Nodes Positive field to 98 [No nodes examined] and the Lymph Nodes Examined to 00 [No nodes examined] because there was no resection of the primary organs. Adenopathy, NOS, per SEER guidelines, is not coded as lymph node involvement | 2002 |
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