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Report Produced: 03/02/2026 05:07 AM

Report Question ID Question Discussion Answer Year
20110120 Surgery of Primary Site--Breast: How is this field coded for a BILATERAL nipple sparing mastectomy given that SINQ 20110094 indicates that a nipple sparing mastectomy should be coded to 30 [subcutaneous mastectomy] but there is no code for bilateral subcutaneous mastectomies? The Surgery of Primary Site field reflects the type of surgery performed on the primary site. In this case, a nipple sparing mastectomy should be coded to 30 [subcutaneous mastectomy]. If the details of the case indicate this is a single primary involving both breasts, code removal of involved contralateral breast under the data item Surgical Procedure/Other Site. 2011
20110058 Date of diagnosis/Flag: Will the Date of Diagnosis Flag ever be used if the instructions for coding Date of Diagnosis are followed? See Discussion.

If an abstractor follows the instructions for coding the Date of Diagnosis and can at least estimate a year of diagnosis, in what scenario will the Flag be used?

Per the 2010 SEER Manual,

Page 49 Date of Diagnosis, second paragraph, "Regardless of the format, at least Year of diagnosis must be known or estimated. Year of diagnosis cannot be blank or unknown." The manual gives the following guidelines for coding diagnosis date/flag:

Page 50, Coding Instructions:

3. If no information about the date of diagnosis is available

a. Use the date of admission as the date of diagnosis

b. In the absence of an admission date, code the date of first treatment as the date of diagnosis.

Page 51, Coding Instructions:

9. Estimate the date of diagnosis if an exact date is not available. Use all information available to calculate the month and year of diagnosis.

Page 53, Date of Diagnosis Flag, Coding Instructions:

Always leave blank. Date of Diagnosis will always be a full or partial date recorded.

 The date of diagnosis flag should always be blank. 2011
20110135

MP/H Rules/Histology--Lung: Per SINQ 20110115, why is micropapillary adenocarcinoma of the lung coded to 8260 [papillary adenocarcinoma] rather than 8050 [papillary carcinoma]?

The histology codes for lung tumors are based on the World Health Organization Classification of Lung Tumors. Chart 1 in the MP/H Lung Equivalent Terms, Definitions, Charts, Tables and Illustrations (2007 MP/H Rules Manual) illustrates the WHO Classification of Lung Tumors.

Using Chart 1, note that papillary adenocarcinoma [8260] is located under the Adenocarcinoma (NOS) branch. The histology in question was stated to be "micropapillary adenocarcinoma" and not "papillary carcinoma." Papillary carcinoma, NOS [8050] is not actually located on the chart. However, papillary squamous cell carcinoma is listed under the Squamous Cell Carcinoma, NOS branch, histology code 8052.

Next, look up papillary carcinoma [8050] in the Morphology - Numerical listing section of the ICD-O-3. Papillary carcinoma, NOS is a Squamous Cell Neoplasm. (Refer also to SINQ 20091040.)

The key word used to determine the appropriate histology in this case is "adenocarcinoma." This is a papillary adenocarcinoma and not a papillary squamous neoplasm.

 2011
20110038

Reportability/Behavior: Is a "minimally invasive thymoma" a reportable malignancy if the pathology report does not specifically state it is malignant? See Discussion.

For example, are Types A, B1, B2 and B3 reportable if the pathology report does not state the tumor is a "Malignant Thymoma"?

For cases diagnosed prior to 2021

According to our expert pathologist consultant, code using the terms in the pathology report. Do not try to second guess the pathologist.

  1. Thymomas are /1 and not reportable unless the pathologist states "malignant". This includes A, AB, B1, B2, and B3. Any one of these types of tumors may exhibit invasion but do not code /3 based only on invasion.

  • Code thymoma as /3 if specifically designated "malignant" by the pathologist.

  • Thymic carcinoma and any of its subtypes are malignant, /3.

    		•  2011
    		20110043 MP/H Rules/Histology--Breast: Which specimen should be used to code histology when a core biopsy revealed an unknown sized DCIS, comedo type and the partial mastectomy specimen showed only a 2mm focus of DCIS, solid pattern? See Discussion.

    Should the histology be coded from the needle core biopsy or the partial mastectomy specimen? Patient had a needle core biopsy that revealed DCIS, comedo type, cribriform pattern, no tumor size given. Subsequently, the patient had a partial mastectomy which revealed DCIS, noncomedo type, solid pattern, largest focus of DCIS was 0.2cm.

    Should the histology code be 8501/2 or 8230/2? The microscopic description on the partial mastectomy says that the previous core needle biopsy site revealed several foci of DCIS.

    		 Code the histology from the most representative specimen (the specimen with the MOST tumor tissue). Compare the size of tumor in the two specimens. If the tumor size is not available for both procedural specimens, code histology from the mastectomy specimen rather than the needle biopsy specimen. 2011
    		20110020 Heme & Lymphoid Neoplasms: How is cancer status to be coded when a patient diagnosed with MDS, undergoes treatment, but the MDS subsequently transforms to AML? If the bone marrow no longer shows evidence of MDS, the cancer status for the MDS is disease-free. When cancer status is coded as disease-free (NED), it means that currently there is no clinical evidence of this disease (MDS). 2011
    		20110118

    Reportability--Colon: Is a polypectomy that is suspicious for invasive adenocarcinoma followed by a partial colectomy with no residual neoplasm reportable? See Discussion.

    08/28/2009 Cecum biopsy showed an adenomatous polyp with focal areas suspicious for invasive adenocarcinoma.

    SINQ 20071060 states a suspicious biopsy that is disproven by a subsequent surgical procedure is not reportable. That does not seem to apply in this case because the patient had a suspicious finding on a surgical procedure (polypectomy), followed by a second surgical procedure that was negative. Is it possible that the polypectomy removed the entire tumor and the suspicious diagnosis should be reported?

    This case is reportable.

    It is possible that the polypectomy removed the entire tumor. Invasive carcinoma in a polyp does not mean that is has invaded the stalk of the polyp. If the stalk is not invaded, all of the cancer may have been removed by a polypectomy.

    		 2011
    		20100106 Reportability-Bladder: Is a case with a cytology diagnosis, "positive for malignancy, favor low grade papillary urothelial carcinoma" reportable if the diagnosis on a subsequent bladder biopsy showed only "urothelial neoplasm of low malignant potential"? See Discussion.

    On 11/23/09 the patient had urine cytology diagnosis "positive for malignancy, favor low grade papillary urothelial carcinoma." On 12/28/09, the bladder biopsy showed "urothelial neoplasm of low malignant potential."

    SINQ 20081086 only addresses the example of a positive FNA/biopsy followed by a negative resection. Would the previous decision hold for this case when a positive fine needle aspiration biopsy is followed by only a negative biopsy?

    This case is not reportable. The pathology proved the cytology to be incorrect. The pathologic diagnosis is the "gold standard." When cytology and pathology disagree, use pathology.

    		2010
    		20100094

    Primary site--Heme & Lymphoid Neoplasms: Is a peripheral blood equivalent to bone marrow biopsy for the purposes of Rule PH26 and code the primary site to C421 [Bone marrow] for a marginal zone lymphoma found in peripheral blood when there was no additional workup (e.g., scans, etc.) for this case?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Code the primary site to C421 [bone marrow]. Our hematopoietic specialty physicians state that involvement of peripheral blood is equivalent to bone marrow involvement because the marrow produces blood. In the absence of any other involvement, per Module 7 (Coding primary sites for lymphomas) Rule PH26, it states to code the primary site to bone marrow when the only involvement is bone marrow.

    SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

    		 2010
    		20100085 Primary site/Histology--Heme & Lymphoid Neoplasms: How are these field coded when a biopsy of a substernal mass and the pericardium show T-cell lymphoblastic lymphoma/leukemia, the CT scan showed mediastinal and hilar adenopathy and no bone marrow biopsy was done?

    For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

    Code the histology to 9837/3 [T lymphoblastic leukemia/lymphoma].

    To determine the primary site for leukemia/lymphoma histologies, first go to Module 4. Per Rule PH8, code the primary site to the site of origin when lymph nodes, tissue or organs are involved. To determine a more specific histology, go to Module 7, rules for coding primary site for lymphomas. Per Rule PH20, code the lymph node region when multiple lymph node chains within the same region are involved. Mediastinal and hilar lymph nodes are intrathoracic lymph nodes. The substernal mass is also intrathoracic and is presumed to be a lymph node mass which involved the pericardium. For this case, code the primary site to C771 [Intrathoracic lymph nodes].

    SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

    		2010