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Report Produced: 11/10/2025 14:11 PM

Report Question ID Question Discussion Answer Year
20041011 EOD-Clinical Extension--Prostate: Should this field be coded to 15 [Tumor identified by needle biopsy for elevated PSA] or 30 [Localized, NOS] when the only information is from a biopsy positive pathology report that includes the clinical history of "PSA elevated, DRE negative," with no mention of an ultrasound being performed?

For cases diagnosed 1998-2003: For this scenario, assign code 15 if an ultrasound was not performed, performed and negative, or when it is unknown whether or not an ultrasound was performed. Assign code 30 only if an ultrasound was performed and there is no documentation stating that it was negative or positive.

Please refer to the Prostate EOD Coding Guidelines for all of the instructions pertaining to the coding of prostate EOD.

 2004
20041095 Primary site: How is this field coded for a malignancy described as a "intracranial squamous cell carcinoma (8070) arising in a previous epidermoid cyst"? See Discussion.

4-5-02 MRI Brain: Enhancing mass is probably a recurrence of the original tumor resected in 1983 (benign). 4-8-02 Gross resection. Lesion was coming up against her brain stem: Removed it grossly.

Path: 4-8-02 Brain tumor, left temporal: SCC arising from a previous epidermoid cyst of the brain. XRT began 4-25-02.

Path states: "Squamous lesions suspicious for malignant transformation of old epidermal cyst (1983). It has been reported in literature that epidermoid cysts in the brain can undergo a malignant transformation which is what happened in this case."

It appears the patient has an intracranial epidermoid cyst that is now

giving rise to SCC. Squamous cell carcinoma (8070) of the brain (C71_) fails the edit Primary Site, Morphology-Imposs ICDO3 (SEER IF38).

 Code the primary site to C760 [Ill-defined site; Head, face or neck, NOS]. There is an intracranial malignancy arising from a previously resected epidermoid cyst. Squamous cell carcinoma, primary of the brain, is a non-overridable edit error. 2004
20051101 CS Extension--Cervix: How are "positive pelvic washings" coded for a cervical primary?

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.

According to the CS Steering Committee, positive pelvic washings for primary cervical cancer are not part of the staging criteria in the collaborative staging system (nor in TNM and FIGO). Document positive pelvic washings in a text field. The CS steering committee will add a statement to CS extension to clarify this for cervix uteri.

 2005
20051128 CS Lymph Nodes/CS Site Specific Factor 3--Breast: How are positive intramammary lymph nodes reflected in these fields? See Discussion. Patient with breast cancer underwent mastectomy. No axillary lymph nodes were positive, but 1 out of 2 intramammary lymph nodes were positive for mets (greater than 2 mm). CS Lymph node codes describe axillary and internal mammary nodes, but do not describe intramammary lymph nodes.

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.

Intramammary lymph nodes are coded as axillary lymph nodes for staging purposes. Intramammary node are nodes within the breast tissue. Both staging and treatment suggest these are equivalent to axillary nodes.

 2005
20051051

CS Lymph Nodes/Reg LN Pos/Exam: Is a final pathologic diagnosis of "Level 8 lymph node: Fibroadipose tissue containing a minute lymphoid aggregate, negative for malignancy" a lymph node for the purpose of coding these fields?

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.

Yes. "Fibroadipose tissue containing minute lymphoid aggregate" qualifies as a lymph node. Include in count as one lymph node examined in the example above assuming this is regional to the primary site.

 2005
20051132 Primary Site/CS Extension/CS Lymph Nodes--Lung: How are these fields coded for untreated lung primaries when only limited information is available from scans, bronchoscopies and biopsies? See Discussion.

3/13/04 CT scan Chest: extensive mediastinal, subcarinal, rt hilar lymphadenopathy; separate tumor mass in medial rt lung

3/16/04 Bronchoscopy: RLL/RML completely obstructed with extrinsic compression. Impression: CA of lung with hilar adenopathy.

Bronchial wash: PD non small cell CA

Bx RLL: up to 0.2 cm PD Adenocarcinoma c/w primary lung CA.

Treatment not recommended.

Expired 5/03/04.

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.

The primary is in the right lung according to the available information.

Assign CS extension code 10 [Tumor confined to one lung]. The only information on extension is that there is a tumor in one lung.

Assign CS Lymph Nodes code 20 [Mediastinal and subcarinal lymph node involvement]. The CT scan confirms mediastinal and subcarinal lymphadenopathy.

Code tumor Size as 999 [Unknown]. "Completely obstructed" is not a size. Do not code the size of the biopsy specimen.

 2005
20051021 Primary Site--Breast: If a patient has multifocal tumors all in the upper outer quadrant of the breast, is the primary site coded to C-504 because all of the tumors are in UOQ or would the site be coded to C509 to reflect the fact that multiple tumors exist? Code the primary site to C504 [Upper outer quadrant]. All disease is located in one quadrant, code that quadrant. When disease involves two or more quadrants and the point of origin cannot be determined, code C509 [Breast, NOS]. See 2004 SEER manual, page C-470 for instructions about invasive and in situ in different quadrants. 2005
20051077 First Course Treatment--Unknown & ill-defined site: We have a case with an unknown primary site and the patient had chemoembolization into the hepatic artery. We don't know how to code this treatment. See Discussion. We were told to code as surgery (10) and chemo (01). However an unknown primary automatically gets a (98) surgery code & the chemo is coded (01) but we can't code as systemic therapy. This is an edit. Chemo coded but no date of systemic therapy.

Effective for cases coded prior to the change in policy made on January 9, 2008, code chemoembolization of a metastatic site as 1 [nonprimary surgical procedure performed] in Surgical Procedure of Other Site.

Surgery of Primary Site code 98 is assigned to all cases with an unknown primary.

In the case of a liver primary, it would be coded 10 [local tumor destruction, NOS] in Surgical Procedure of Primary Site.

 2005
20051040 Primary Site--Sarcoma: What is the correct topography code for a partial lung lobectomy with pathology diagnosis of "pulmonary sarcoma with smooth muscle differentiation"? See Discussion.

Operative report: palpable 2x2cm mass in the mediastinal surface of the rt middle lobe and the contiguous upper lobe together.

Path comment after partial lung lobectomy: In all likelihood this is a malignant process occurring in smooth muscle changes surrounding vessels within the lung versus an undifferentiated epithelial tumor.

ADDENDUM DX: low grade pulmonary sarcoma with smooth muscle differentiation.

Consultant's report concurs with that of the original pathologist's report of malignant neoplasm compatible with smooth muscle origin.

 This case is unique. Assign topography code C493 [Connective, subcutaneous and other soft tissue of thorax]. Based on the information provided, this sarcoma has smooth muscle differentiation and originated in the muscle. Code the primary site to muscle. 2005
20051063 Primary Site/CS Tumor Size/CS Extension--Lung: How are these fields coded when a chest CT for lung cancer documents multiple masses in different lobes of the lung? See Discussion.

Example

Chest CT: "Almost complete consolidation of RUL and superior segment of RLL, highly suspicious for malignancy and represents primary bronchogenic carcinoma until proven otherwise. Multiple pulmonary masses bilaterally consistent with metastatic disease."

The physician describes multiple masses throughout RLL and LLL of lung suspicious for met disease, particularly lesion in LLL measuring 2.5 cm. The 2 cm mass in right lung abuts pleura, another mass in RLL measures 2.5 cm, smaller nodules in RLL and another 1 cm lesion abuts the pleura. Bx of a rt supraclavicular LN is positive for met carcinoma c/w lung primary.

Would primary site be coded to RLL because the scan states that the lesions on the right side represent primary bronchogenic carcinoma until proven otherwise and the 2.5 cm lesion in the RLL is the location of the largest tumor on the right? Or should site be coded to right lung, NOS and size to unknown because there is no clear statement as to which lesion on the right represents the primary tumor? If the site is lung, NOS, would CS Extension be coded to 65 to describe the multiple nodules in the RLL?

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:

Code primary site C349 [Lung]. Code laterality 1 [Right]. Code CS Tumor Size 999 [Unknown]. Code CS Extension 65 [Separate tumor nodules, same lobe]. Code CS Mets at Dx 39 [Separate tumor nodule in contralateral lung].

 2005