Date of Diagnosis/Histology--Hematopoietic, NOS: How are these fields coded if a 3/17/03 bone marrow biopsy diagnosis of "malignant proliferative disorder" is subsequently confirmed to be a "low grade lymphoma" per a bone marrow biopsy in early 2006? See Discussion.
3-17-03: Bone marrow biopsy from rt iliac crest: Hypercellular marrow (90%) with extensive involvement by lymphoproliferative disorder (see description). Micro: The bone marrow is diffusely (>90%) involved by a malignant lymphoproliferative disorder. This consists of small lymphocytes,histiocytes, and large atypical cells with prominent nucleoli.
12-22-05 Extensive bone marrow involvement by lymphoproliferative disorder, bone biopsy from femur.
1-27-06 Hem/Onc Physician Note:
following pt for a lymphoproliferative disorder. ...bone marrow biopsy 2003, suggestive of, but not truly diagnostic, a lymphoproliferative disorder. Therefore, I elected not to do anything, but just follow her.
3-23-06 Hem/Onc Note:
pt with a history of an apparently low-grade lymphoma involving the marrow, as well as, I believe, the liver and recently pathologically diagnosed as a T-cell-rich B-cell lymphoma. ...followed in the past by Dr. ___ and has never actually had any treatment for this lymphoma, although it is documented even three years ago by bone marrow biopsy.
For cases diagnosed prior to 1/1/2010:
Code the diagnosis date to 3/17/03. The histology code is 9970/3 [Malignant myeloproliferative disorder]. The bone marrow biopsy confirms a "Malignant" lymphoproliferative disorder. Apply ICD-O-3 rule F and assign /3 to histology code 9970.
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.
Histology (Pre-2007): Is histology for an anorectal biopsy of "Cloacogenic carcinoma (squamous cell carcinoma with basaloid features)" coded to 8124/3 [Cloacogenic carcinoma] or 8083/3 [Basaloid squamous cell carcinoma]?
For tumors diagnosed prior to 2007:
Code histology to 8124/3 [Cloacogenic carcinoma]. These are squamous cell carcinomas of basaloid type that are found in the cloacogenic (transitional) zone of the anal canal.
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.
Histology (Pre-2007)--Bladder: How is a "carcinoma with squamous, mucinous, and signet ring cell features" coded?
For tumors diagnosed prior to 2007:
Code histology to 8490 [Signet ring cell carcinoma]. Rule 7 on page 87 of the 2004 SEER Manual applies to this case.
Rule 7: Code the numerically higher ICD-O-3 code. This is the rule with the lowest priority and should be used infrequently.
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.
Behavior--Head & Neck: Should the SEER IF_Morph_3 edit be modified because it does not allow a behavior code 2 with histology 8941 [carcinoma in a pleomorphic adenoma] for a parotid primary?
Code the behavior as 2 and over-ride the edit. The edit is there to flag unusual combinations. Once you have verified that the behavior is coded correctly, over-ride the edit.
The surgeon stage of T2 is based on size of tumor, the TIS is based on behavior. Code according to pathologically confirmed TIS.
Histology--Leukemia: How is a "plasmacytoid dendritic cell leukemia/lymphoma" coded when it is discovered on a bone marrow biopsy for a patient who presented with multiple enlarged lymph nodes and the discharge diagnosis was Type 2 plasmacytoid dendritic cell leukemia?
For cases diagnosed prior to 1/1/2010:
The best code currently available for this entity is 9727/3 [precursor cell lymphoblastic leukemia].
The WHO classification refers to this as "Blastic NK-cell lymphoma." The 2005 WHO-EORTC classification for cutaneous lymphomas states that blastic NK-cell lymphoma may be derived from a plasmacytoid dendritic cell precursor. They suggest more appropriate terms for this condition may be "CD4+/CD56+ hematodermic neoplasm," and "early plasmacytoid dendritic cell leukemia/lymphoma." According to WHO, this is a rare form of lymphoma.
Willemze, et al. WHO-EORTC classification for cutaneous lymphomas. Blood, 15 May 2005. Volume 105, Number 10.
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.
Reportability--Melanoma: Is the following reportable? See Discussion.
PATH: Skin, Lt back exc bx: compound nevus with severe cytoarchitectural atypia and regression. Comment: due to overlap of morphology between MM and nevi with severe atypia, and since there's evidence of regression, consideration for re-excision may be considered if clinically indicated.
The final diagnosis, compound nevus with severe atypia, is not reportable. This diagnosis is not listed in ICD-O-3.
Histology (Pre-2007)--Melanoma: How is a "plaque-like nodular spitzoid malignant melanoma" coded?
For tumors diagnosed prior to 2007:
Code histology to 8721 [nodular melanoma]. Essentially, "plaque-like nodular spitzoid malignant melanoma" is nodular melanoma. Code 8721 is the most specific ICD-O-3 histology code available for this diagnosis.
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.
Chemotherapy--Breast: Is chemotherapy administered for inflammatory breast cancer also coded as therapy for an in situ tumor in the contralateral breast?
Yes. Because chemotherapy would likely affect both primaries, code it as treatment for both the in situ and the inflammatory breast cancers.
Diagnostic Confirmation: How is this field coded for a case with a cytology that is suspicious for ductal carcinoma and the clinical diagnosis is carcinoma? See Discussion.
SINQ 20031152 states that histology for this type of case is to be coded per the clinical diagnosis of "carcinoma." Does it follow then that Diagnostic Confirmation is to be coded 8 (clinical diagnosis only)? Would we code Diagnostic Confirmation differently if the clinician stated that the diagnosis of malignancy was confirmed by the suspicious cytology?
Code diagnostic confirmation as 8 [clincial diagnosis] when there is a suspicious cytology and a physician's clinical diagnosis. Do not accession cases with only suspicious cytology.
Code diagnostic confirmation as 8 when the clinician's diagnosis of malignancy is confirmed by the suspicious cytology. It is still a clinical diagnosis made by the physician using the information available for the case.
CS Lymph Nodes--Lung: If the lymph nodes listed in codes 10 and 20 were contralateral or bilateral, and the only description was "mass", "adenopathy", or "enlargement" on mediastinoscopy or x-ray, is this field coded to 60? See Discussion.
(CS Manual page 407) Note 2: If at mediastinoscopy/x-ray, the description is "mass", "adenopathy", or "enlargement" of any lymph nodes named as regional in codes 10 and 20, assume that at least regional lymph nodes were involved.
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. The named nodes listed in codes 10 or 20 should be coded 60 if the "mass", "adenopathy", or "enlargement" on mediastinscopy or x-ray is described as bilateral or contralateral.
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