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For cases diagnosed 1998-2003, code EOD using the best information available. In this example, the post-treatment description of lymph nodes. A post-treatment description of lymph nodes can be used to code lymph node involvement in the absence of disease progression. Pre-operative treatment does not affect lymph node involvement.

Case example: Code lymph nodes as involved (codes 1-4 depending on size and number) based on the later CT report.

For cases diagnosed 1998-2002:

Code the Reason for No Cancer-Directed Surgery field to 1 [Cancer-directed surgery was not recommended] for patients who present with either a primary site or histology for which surgery is not a standard treatment. Also use code 1 for those patients who present with distant disease for a primary site that is typically treated surgically. Patients with distant metastasis typically do not have surgery performed as part of first course of treatment.

Code 2 [Contraindicated due to other conditions] is used when surgery would normally be recommended for the site (given the current stage of the tumor) but other medical conditions pose too much of a risk for the patient to undergo surgery.

For cases diagnosed 1998 and later:

Code the Surgery of Primary Site field to 17 [Other method of local tumor destruction]. HIFU uses focused energy to destroy tissue. It is classified as a surgical procedure.

For cases diagnosed 1/1/2010 and later, use the Hematopoietic & Lymphoid Neoplasm Manual for instructions on coding aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

For cases diagnosed 5/1/2002 12/31/2009, use the instructions in the SEER Manual and the instructions in "Abstracting and Coding Guide for the Hematopoietic Diseases" to code aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

For cases diagnosed 1/1/2001 04/30/2002 use the instructions in the SEER Manual for collection of aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."

Prior to 1/1/2001, these treatment modalities were not collected.

For cases diagnosed 1/1/2003 to 12/31/2010: Code Zoladex (gosrelin) and Lupron (leuprolide acetate) as 01 [Hormone therapy administered as first course therapy] only when stated to be given as part of the first course of cancer-directed therapy. If you do not know whether these drugs were given to preserve ovarian function or as an adjunct to chemotherapy (i.e, there is no treatment plan), do not code as Hormonal treatment given.

For cases diagnosed 1/1/2003 and later: When "watchful waiting" is the first course of therapy for prostate cancer, code the case as follows:

Date Therapy Initiated: 000000

Surgery of Primary Site: 00

Scope of Regional Lymph Node Surgery: 0

Surgical Procedure of Other Site: 0

Reason for No Cancer-Directed Surgery: 1

Radiation: 0

Chemotherapy: 00

Hormone Therapy: 00

Immunotherapy: 00

Hematologic Transplant and Endocrine Procedures: 00

Other Cancer Directed Therapy: 0

For cases diagnosed 1/1/2003 and later: Code Scope of Reg LN Surgery to 7. Code EOD Lymph Nodes field to 6. Code EOD Pathologic Number of Reg LN Positive and Examined fields to 01 and 09 respectively.

For the Scope of Reg LN Surgery use the highest applicable code number if more than one Scope of Reg LN Surgery was performed. The EOD lymph node fields are cumulative and count all lymph nodes removed during the diagnostic and first course treatment procedures.

For cases diagnosed 1/1/2003 and after:

1. Code hormone therapy to 01. Code any therapy administered to treat cancer tissue that achieves its effect on cancer tissue through a change in the hormone balance in the hormone therapy field. Decadron is coded for leukemias, lymphomas and multiple myelomas primaries. It is coded for other sites only when stated to be cancer-directed treatment.

2. Code hormone therapy to 01. Decadron should be coded as hormone therapy for multiple myeloma when given alone or as part of a first course of treatment chemotherapy regimen.

For cases diagnosed 1/1/2003 and after: Yes, all of the lymph node information should be coded to the Scope of Regional Lymph Node Surgery field using code 7 [Sentinel node biopsy and code 3, 4, or 5 at different times].

The Number of Regional Lymph Nodes Examined field no longer exists for this time frame.

For cases diagnosed 1/1/2003 and after: Code the Surgical Procedure of Other Site field to 3 [Non-primary surgical procedure to distant lymph nodes] for an excision of a distant lymph node because it is a surgical procedure. However, if only a fine needle aspirate of a distant lymph node is done, code this field to 0 [None].

Fine needle aspirates of regional lymph nodes are the only FNA biopsies to be coded in a surgery field (Scope of Regional Lymph Node Surgery field). In addition, FNA biopsies of regional nodes are also included in the EOD-Number of Positive Regional and Examined Lymph Nodes fields.