Radiation Sequence with Surgery--Head & Neck: How is this field coded for a tonsil primary diagnosed on 4/16/07 by a regional lymph node FNA when the patient subsequently initiates radiation on 5/8/07 and has a tonsillectomy with neck dissection on 7/30/07?
The best way to handle this situation is to assign code 2 [Radiation before surgery] in Radiation Sequence with Surgery. Code 2 provides the best description of the sequence of events in this case. Radiation was delivered prior to the resection of the primary site.
CS Extension--Ovary: How are the following terms coded when they are described in the medical record without any other qualifying information? Seeding, talcum powder appearance, salting, miliary, and studding.
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.Seeding, talcum powder appearance, salting and studding are synonymous with implants. When the size of implants is not stated, but operative report and scans state "seeding," "talcum powder appearance," "salting," and "studding" the CS extension code choice will depend on the location of the seeding, talcum powder appearance, salting, or studding.
The word "miliary" is not documented as a synonym for implants.
The term miliary does not affect the CS extension code choice according to the current CS instructions.
EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?
For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.
Histology (Pre-2007)--Kidney: Is 8316/3 [Cyst associated renal cell carcinoma] the appropriate code for 1) Cystic renal cell carcinoma, 2) Renal cell carcinoma mass with cystic areas and 3) Cystic renal cell carcinoma, clear cell type?
For tumors diagnosed prior to 2007:
Yes, ICD-O-3 histology code 8316 is the correct code for the three examples above.
There are two categories of cyst-associated renal cell carcinomas: Renal cell carcinoma originating in a cyst, and Cystic renal cell 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.
Reportability/Histology--Soft Tissue: Is atypical spindle cell neoplasm, primitive myxoid mesenchymal tumor of infancy (PMMTI) from the soft tissue of the leg in August of 2019, reportable?
Primitive myxoid mesenchymal tumor of infancy (PMMTI) is reportable. PMMTI is listed in the new WHO 5th edition Classification of Soft Tissue and Bone Tumors under round cell sarcomas. This is a variant of BCOR sarcomas. There is a new ICD-O histology code assigned for cases diagnosed in 2022 or later (9368/3). Code this 2019 case to round cell sarcoma, undifferentiated 8803/3. Use text fields to explain the details.
MP/H Rules/Histology--Thyroid: How is histology coded for a thyroid tumor described as "predominantly papillary carcinoma, tall cell variant, follicular type"?
For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites.
"Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored.
First Course Therapy/Surgery of Primary Site--Prostate: What is the correct surgical code for irreversible electroporation ablation of the prostate diagnosed in 2021?
Assign code 17 for irreversible electroporation ablation of the prostate when there is no tissue submitted to pathology for a 2021 or 2022 case.
Grade, Differentiation--All Sites: What code is used to represent this field when a pathology report describes a tumor as a low grade neoplasm consistent with a specific histologic type (e.g., Low grade neoplasm consistent with carcinoid)?
Code the Grade, Differentiation field to 2 [Low grade].
Reportability--Brain and CNS: Is this diagnosis reportable? If this neoplasm originated in the spinal cord, it is reportable, correct?
Specimen is described as a 'spinal cord mass.' The final diagnosis is 'fragments of adipose tissue demonstrating vascular proliferations consistent with angiolipoma. No histologic evidence of malignancy.' The microscopic description says: Sections of the spinal mass reveal bone, cartilage, fibrous tissue and adipose tissue. The adipose tissue demonstrates increased vascularity with thin walled blood vessels seen with islands of delicate fibrous stroma. The histologic findings are compatible with fragments of angiolipoma.
The neoplasm is reportable if it originated in the spinal cord or is intradural (within the spinal dura; spinal nerve roots are intradural). If there is not enough information to determine the exact site of origin, do not report the case.
MP/H Rules/Multiple primaries--Breast: Is this the same primary per MP/H Rule M10? Ductal carcinoma of the left breast in 2013, treated with a lumpectomy. New tumor with ductal and lobular carcinoma in the same breast in 2016.
The 2016 diagnosis is the same primary. MP/H Rule M10 for breast cancer applies. Do not change the original histology code. Use text fields to document the later histologic type -- duct and lobular.
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