| Report | Question ID | Question | Discussion | Answer | Year |
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20031005 | Histology (Pre-2007): Do the terms "keratinizing" or "non-keratinizing" have to be present in the final diagnosis to use codes 8071 through 8073? See discussion. | Should "squamous cell carcinoma, small cell variant" be coded to 8073 even though the final diagnoses does not include the phrase "non-keratinizing?" | For tumors diagnosed prior to 2007:
It is acceptable to assign code 8073/3 for squamous cell carcinoma, small cell, NOS. Code squamous cell carcinoma, large cell, NOS to 8072/3. Code to non-keratinizing unless the pathology report specifies keratinizing.
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. |
2003 |
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20031006 | EOD/Surgery of Primary Site--Melanoma: If a melanoma primary site is other than skin, vulva, penis, or scrotum should these fields be coded using melanoma schemes? See discussion. | Should a melanoma of the cervix be coded using the melanoma or the cervix schemes for these fields? | For cases diagnosed 1998-2003: Use the EOD and surgery code schemes for cervix uteri. The EOD scheme for melanoma excludes melanoma of the cervix uteri. The surgery code scheme for skin excludes cervix uteri. | 2003 |
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20000547 | Histology (Pre-2007): What code is used to represent the histology "non-small cell carcinoma, NOS"? See discussion. | Should a non-small cell carcinoma histology be assumed to be a large cell carcinoma [8031/3] or should the histology be coded to carcinoma, NOS [8010/3]? | For tumor diagnosed 2001-2006: Code the Histology field to 8046/3 [non-small 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. |
2000 |
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20041021 | Histology (Pre-2007)--Corpus Uteri: How should this field be coded when the D&C which shows "adenocarcinoma with mucinous and papillary features" and the TAH demonstrates only "endometroid carcinoma"? See Discussion. | Should Histology be coded to 8380 [endometroid adenocarcinoma] because it is the most representative sample or to 8323 [mixed cell adenocarcinoma], per the Complex Morphology Coding Guidelines? The instructions in the Guidelines seem to imply that it is most important to represent combination histologies first, with majority (most representative sample) of tumor having a lower priority. | For tumors diagnosed prior to 2007:
Code Histology based on the pathology report from the most representative tissue. For the example above, code Histology to 8380 [Endometroid adenocarcinoma] based on the TAH/BSO pathology report.
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 |
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20010065 | Histology (Pre-2007): What codes are used to represent the histology "mucinous adenocarcinoma arising in a villous adenoma" and "mucinous adenocarcinoma arising in a villous glandular polyp"? See discussion. | Should histology be coded to 8480/3 [mucinous adenocarcinoma] or 8261/3[adenocarcinoma arising a villous adenoma] or 8263/3 [adenocarcinoma in a villoglandular adenoma]? | For tumors diagnosed prior to 2007:
Code the Histology field to 8480/3 [mucinous adenocarcinoma] using rule D in the Coding Complex Morphology Diagnoses: "Code the morphology with the highest 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. |
2001 |
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20021115 | EOD-Lymph Nodes--Testis: In coding lymph node involvement for a testicular primary, should we use code 5 (Size not stated) when there is not a pathologic size of the lymph node provided? See discussion. | Should Note 1 in the testis EOD be changed to "Metastases in lymph nodes are now measured by the size of the lymph node as stated in pathology report"? The SEER EOD-88, 3rd Edition, states that "when size of regional lymph nodes is required, code from the pathology report." | For cases diagnosed 1998-2003:
For testis cases only, "metastasis in lymph nodes" is measured by the size of the lymph node or the lymph node mass. It is acceptable to code the size of this metastasis from a CT scan or other imaging when a pathology specimen is not available for testicular primaries. |
2002 |
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20061138 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Breast: How many primaries are to be abstracted and how is the histology field(s) coded when a nipple biopsy demonstrates Paget disease and a separate biopsy in the same breast demonstrates inflammatory breast carcinoma? See Discussion. | Should Paget disease be coded as the histology because it has a higher histology code than inflammatory carcinoma? | For tumors diagnosed prior to 2007:
Abstract the inflammatory carcinoma as one primary and the Paget disease as a separate primary. The first three digits of the histology codes for these histologies are different (8530 and 8540). Therefore, these are separate 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. |
2006 |
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20021136 | Date of Diagnosis/Histology (Pre-2007): How should we code these fields for "atypical fibroxanthoma" of the left cheek diagnosed in October 1999 that is followed by a June 2000 punch biopsy with a microscopic description in the pathology report of "superficial form of malignant fibrous histiocytoma"? See discussion. | Should the diagnosis date for the malignant fibrous histiocytoma be October 1999 because it is called "residual/recurrent atypical fibroxanthoma" in the June 2000 final diagnosis of pathology report? In the microscopic description it is called a "malignant fibrous histiocytoma." Per an August 2000 outpatient note, "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." | For tumors diagnosed prior to 2007:
Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.
If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.
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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20010003 | Histology (Pre-2007)--Prostate: What code is used to represent the histology "prostatic duct carcinoma"? See discussion. | Should the histology be coded to duct carcinoma [8500/3] or endometrioid carcinoma [8380/3]? Prostatic duct carcinoma is defined as endometrioid carcinoma; however, sometimes the pathology report describes the histology as being only "prostatic duct carcinoma." | For tumors diagnosed prior to 2007:
If there is no mention of endometrioid carcinoma in the microscopic description, code the Histology field to 8500/3 [duct carcinoma]. If "endometrioid carcinoma" is mentioned in either the final diagnosis or in the microscopic description, code the Histology field to 8380/3 [endometrioid 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. |
2001 |
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20120070 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are accessioned when a bone marrow biopsy shows myelodysplastic syndrome - refractory anemia with excess blasts type 2 (RAEB-2) and myelofibrosis? See Discussion. | Should the myelofibrosis be accessioned as a second primary? Or is it a descriptor of the MDS/RAEB-2? The multiple primaries calculator shows 9983/3 and 9961/3 represent two primaries. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Accession a single primary per Rule M2 which indicates you are to abstract a single primary when there is a single histology. Code the histology to 9983/3 [refractory anemia with excess blasts type 2 (RAEB-2)].
Per Appendix F, myelofibrosis, NOS, is NOT a synonym for primary myelofibrosis. Myelofibrosis, NOS, if not specified to be myelofibrosis, therefore, is not reportable.
Per PH29, code the specific histology when the diagnosis is one non-specific (NOS) histology (MDS) and one specific histology (RAEB-2) AND the Multiple Primary Calculator confirms the specific histology and NOS histology are the same primary (which it does).
Myelodysplastic syndrome, NOS is a generic disease description. In most cases, NOS histology is only the provisional diagnosis; the physician will run further diagnostic procedures and look for various clinical presentations to identify a more specific disease. The more specific myelodysplastic syndromes are: refractory anemia; refractory neutropenia; refractory thrombocytopenia; refractory anemia with ring sideroblasts; refractory cytopenia with multilineage dysplasia; refractory anemia with excess blasts; and refractory cytopenia of childhood. If the characteristics of a specific subtype of MDS develop later in the course of the disease, change the histology code to the more specific diagnosis.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2012 |
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