CS Tumor Size--Bladder: Is tumor size coded to 080 when the bladder mass is described as "greater than 8 cm in diameter"?
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.Based on the information provided above, code CS tumor size 080 [8 cm]. Code the information that is avaliable. Since size of tumor is not used to stage bladder cancer, an approximation is adequate.
EOD-Extension: General instructions, page 7, note 3 states: " Extent of disease information obtained after treatment with neoadjuvant chemotherapy, hormone or immunotherapy has begun may be included." Because the SEER manual does not mention radiation treatment, can we use information from a lobectomy to code EOD if a patient has neoadjuvant radiation therapy?
Radiation therapy was inadvertently omitted from the list. Please see SINQ 20031012 answer as to when the surgical information can be used to stage the case.
Primary site--Heme & Lymphoid Neoplasms: What is the primary site for a bone marrow biopsy positive for systemic mastocytosis that also involves the spleen and lymph nodes with associated leukocytosis, mild anemia and thrombocytopenia?
Per Rule PH30, one is to use the to determine the primary site and histology when rules PH1-PH29 do apply. Code the primary site to C421 [bone marrow] because that is the only site listed under the Primary Site section of the Heme DB.
Under the Abstractor Notes section in the Heme DB, it indicates that the bone marrow is always involved, and the white and red pulp of the spleen may be involved with systemic mastocytosis. This is how this patient presented; therefore, the bone marrow is the primary site. The spleen is secondarily involved because the spleen cleanses the blood and the neoplastic cells have infiltrated the red and white pulp of the spleen. The same is true for the lymph nodes. Although the lymph nodes are rarely involved, they may be involved when the patient has systemic mastocytosis.
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.
Multiplicity Counter--Ill-defined sites: How is this field coded for Ill-Defined sites (C760-C768)?
Code the number of tumors present if known. If the number of tumors present is not known, code 99 [unknown number of tumors, unknown if multiple tumors].
MP/H Rules--Colon: What histology would you assign to a single tumor with the histology 'well differentiated mucinous cystadenocarcinoma in a villous adenoma confined to the appendix'? Does rule H4 apply to this diagnosis or should we continue on in the rules to H14 and code the higher histology?
For cases diagnosed 2007 or later, use rule H4.
Stop at the first rule that applies to the case. Rule H4 is the first rule that applies.
The polyp rule, H4, comes before many of the other colon rules because it is important to know that the malignancy originated in a polyp.
Histology (Pre-2007): What code is used to represent the histology "non oat cell carcinoma"?
For tumors diagnosed 2001-2006:
Code the Histology field to 8046/3 [non-small cell carcinoma] if the pathologist does not provide a more specific histologic type. "Non oat cell" is a synonym for "non-small cell."
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.
Diagnostic confirmation--Heme & Lymphoid Neoplasms: Is Diagnostic Confirmation coded as 5 (positive laboratory test/ marker study) or code 8 (clinical diagnosis only) for a case that has a positive JAK2 mutation, and based on the results of the JAK2, the physician diagnosed the patient with polycythemia vera? There were no blood smears or bone marrow biopsies done.
Assign diagnostic confirmation code 5 for a positive laboratory test/marker study. A note was added to the Hematopoietic manual to state that code 5 now includes cases with no histological confirmation but there is positive immunophenotyping or genetic studies.
Update to current manual/Solid Tumor Rules (2018)/Histology--Brain and CNS: Table 6 (Non-Malignant CNS Equivalent Terms and Definitions) lists as a subtype/variant of craniopharyngioma 9350/1. This is not a valid histology per the ICD-O-3 or the 2018 ICD-O-3 Update Table. Is this actually supposed to read, ?
Adamantinomatous craniopharyngioma (9351/1) is a subtype of craniopharygioma. We will correct the Non-Malignant CNS Solid Tumor Rules in the next update.
Histology (Pre-2007)--Breast: What code is used to represent the histology "invasive ductal carcinoma, mucinous type and invasive lobular carcinoma"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8522/3 [infiltrating duct and lobular carcinoma] per rule 1 of the Coding Complex Morphologic Diagnoses, because the tumor is both lobular and ductal.
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.
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