Reportability--Eye: Is conjunctival intraepithelial neoplasia (CIN III) from an excision of the left eye conjunctiva reportable?
Conjuctival intraepithelial neoplasia grade III (CIN III) is reportable. Intraepithelial neoplasia, grade III, is listed in ICD-O-3 as /2. It is reportable for sites other than skin.
CS Extension--Head & Neck (Larynx): If a patient with cancer of the larynx is described as experiencing hoarseness, is that sufficient information to code "vocal cord fixation" or does that phrase need to be used?
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.
Do not code vocal cord fixation when the only information available is "hoarseness." Vocal cord fixation must be documented on endoscopy. Hoarseness is a common presenting symptom of laryngeal malignancy.
Histology (Pre-2007)/Multiple Primaries (Pre-2007)--Breast: What code is used to represent histology for a case with a biopsy specimen that reveals "infiltrating ductal carcinoma with ductal carcinoma in situ, comedo subtype, non-extensive" in one quadrant of the breast and a mastectomy specimen with "invasive pleomorphic lobular carcinoma with lobular carcinoma in situ" in another quadrant of the breast? Paget disease is identified in the nipple section.
For tumors diagnosed prior to 2007:
Code the Histology field to 8522/3 [infiltrating duct and lobular carcinoma]. We are choosing the ductal and lobular combination over the Paget disease and lobular combination because it is more important for analysis purposes.
Be careful in using combination codes to code separate tumors in different locations of the same breast as a single primary. Currently there are only three combination codes for the breast that allow for this situation, 8522 [duct and lobular], 8541 [Paget disease and infiltrating duct] and 8543 [Paget disease and intraductal]. Other histologic type differences that occur as separate tumors in different parts of the same breast are coded as multiple 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.
MP/H Rules/Histology--Bladder: Can the histology for a high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" be coded to sarcomatoid transitional cell carcinoma (8122/3)?
Example; TURBT, Final Diagnosis - Urothelial carcinoma, high grade. Type/grade comment: Extensive sarcomatoid dedifferentiation is present (40-50% of tumor volume).
Code high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" to sarcomatoid transitional cell carcinoma (8122/3).
CS Eval--All Sites: If any of the CS fields (TS/Extension, LN, or Mets) are based on the TNM and there is no text documenting the basis for the evaluation, are the evaluation fields coded to 0 instead of 1?
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.
Assign code 0 [No surgical resection done...based on physical exam...or other non-invasive clinical evidence] to the corresponding eval fields when CS Extension, Lymph Nodes or Mets at Diagnosis are coded based only on the TNM and no further information is available.
When coding the Covid testing results, does SEER have any guidance on whether or not at home tests fall within reportability? For instance, if a medical provider says pt tested positive on an at home test, do we record that?
When you have information about home COVID tests, record this information. For example, if the home test was positive record as follows: COVID-19 rapid viral antigen test POS 08/09/2022
EOD-Extension--Lymphoma: What code is used to represent this field for a lymphoma that involves the spleen and lymph nodes above the diaphragm (e.g., involvement of only the spleen below the diaphragm and cervical lymph nodes above the diaphragm)?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 32 [30 + involvement of the spleen; III S]. The spleen is counted twice (once as the spleen and a second time as a lymph node region below the diaphragm). As a result, the EOD-Extension field is coded to reflect involvement of lymph node regions on both sides of the diaphragm plus involvement of the spleen. See Note 1 on the EOD scheme that states "Any lymphatic structure is to be coded the same as a lymph node region."
CS Lymph Node Examined--Lung: How is this field coded when a mediastinoscopy and lobectomy are performed and the pathology report indicates multiple lymph node fragments were removed as biopsy specimens and the lobectomy specimen revealed 3 interlobar 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.
Code the CS Lymph Node Examined field to 98 [number unknown] because the biopsy information is not clear and as a result you do not know how many lymph nodes were examined.
CS Extension/CS Mets at Dx--Corpus uteri: Is a microscopic metastasis in a cul-de-sac implant more appropriately reflected in the CS Extension field code 80 [Further contiguous extension; cul-de-sac] or in the CS Mets at Dx field code 40 [Distant metastasis]?
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.Assign code 80 [Further contiguous extension; Cul de sac] for CS extension in this case. Endometrium and ovary are exceptions to the rules that only contiguous extension is coded in Extension code 80. Only true distant metastases are coded in Mets at Dx.
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