Reportability--Anus: Is a final diagnosis on a pathology report of "squamous cell carcinoma of the anus, NOS" assumed to be a skin of anus primary or a primary of the anus?
Squamous cell carcinoma of the anus is reportable unless known or stated to be skin of anus.
Primary Site/Sarcoma--Breast: Is the primary site coded to C504 [upper-outer quadrant of breast] or C493 [ Connective, subcutaneous and other soft tissue of thorax ] for a tumor described as a "high grade soft tissue sarcoma present in the upper outer quadrant of breast"?
If the sarcoma is primary in the breast, code the primary site to C504 [upper-outer quadrant of breast]. C500 - C509 includes soft tissue of breast.
Birthplace/Place of birth, country: For patients originally born in a country that is currently listed as "historic only", where the original birth country now has a one-to-many relationship with the current country, how should the reported original birthplace be coded? (Example: Yugoslavia)
Assign code for Europe, NOS (ZZE) for Yugoslavia, NOS, without further information.
Surgery of Primary Site--Bladder: Should a TURB be coded to 27 [Excisional biopsy; SEER Note: Code TURB as 27] when there is obvious extravesicular extension demonstrated because the 2004 SEER Manual states "Do not code an excisional biopsy when there is macroscopic residual disease"?
Assign code 27 [excisional biopsy]. The site-specific instructions have priority over the general instructions. According to the instructions for coding surgery of the bladder, use code 27 for TURB.
Grade, Differentiation--Prostate: Has SEER officially changed the conversion code for Gleason score 7 to grade 3 [poorly differentiated] for cases diagnosed in 2003 or later?
For prostate cases diagnosed in 2003 and forward: convert Gleason score 7 to grade 3 [poorly differentiated].
Reportability--Skin: Effective 2021, a cutaneous leiomyosarcoma is a related term for smooth muscle tumor, NOS (8897/1) in ICD-O-3.2. Currently, we have been capturing these as a C44_ (leiomyosarcoma, 8890/3) but the 2019 SEER inquiry states that atypical intradermal smooth muscle neoplasm (AISMN) was previously termed cutaneous leiomyosarcoma. This is not documented on the 2018 ICD-O-3 updates. Should this 2019 case be 8897/1 or 8890/3?
Cutaneous leiomyosarcoma is reportable for 2019. Code histology to leiomyosarcoma 8890/3.
As of cases diagnosed 1/1/2021, it is no longer reportable based on assignment to 8897/1 in ICD-O-3.2.
Primary Site/EOD-Extension--Kaposi Sarcoma: How are these fields coded for localized disease described as "Nodal Kaposi Sarcoma" found on inguinal node biopsy only?
Code the site of involvement as the primary site when no other involvement is documented. For the case above, code C774 [inguinal lymph node] as primary site.
For cases diagnosed 1998-2003: Code EOD-extension as 13 [Visceral].
First Course Treatment--Prostatic Urethra: Is Lupron coded for a papillary carcinoma of the prostatic urethra that is treated with a TUR with fulguration and beam radiation even though the prostate biopsies are negative?
Do not code lupron as treatment for a primary in the prostatic urethra.
Reportability/Histology--Pancreas: Is mucinous cystic neoplasm of pancreas reportable?
Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with low or intermediate grade dysplasia is NOT reportable.
Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with high grade dysplasia is reportable. For neoplasms of the pancreas, the term MCN with high grade dysplasia replaces the term mucinous cystadenocarcinoma, non-invasive.
MP/H Rules/Histology--Prostate: If a patient is stated to have prostate "cancer" but a pathology report is not available nor is a specific histology stated in the medical record, can this histology be coded to 8140 [adenocarcinoma] instead of 8000/3 [cancer] because the vast majority of prostate cancers are adenocarcinomas?
For cases diagnosed 2007 and later, the correct histology code is 8000/3 [cancer]. The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Other Sites Histology rules because no specific rules have been developed for prostate primaries.
To determine the histology, start at the SINGLE TUMOR: INVASIVE ONLY module, rule H8. The rules are intended to be reviewed in consecutive order within a module. Code the histology documented by the physician when there is no pathology/cytology specimen or the pathology/cytology report is not available. Code the histology as 8000/3 [cancer] because that is the only available information. In the absence of a pathology report or any other histologic confirmation, code the histology based on the information available.
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