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Report Produced: 03/02/2026 08:03 AM

Report Question ID Question Discussion Answer Year
20100039

Casefinding--Heme & Lymphoid Neoplasms: Is the 2010 casefinding code of 289.6 (Familial Polycythemia) addressed anywhere in the Hematopoietic Database? See Discussion.

When you enter "familial polycythemia" into the Heme DM, polycythemia vera (PV) appears; however, the term "familial polycythemia" is not listed as one of the synonyms for PV.

Familial polycythemia by itself is not reportable. This is a benign condition which occurs within families. Familial polycythemia can progress to polycythemia vera (9950/3), which would then be reportable. The code, 289.6, which is the ICD-9-CM code for Familial polycythemia is not included on the reportable list for casefinding. There is only one ICD-9-CM code for Polycythemia vera, 238.4. "Familial polycythemia" is listed in Appendix F: Non-Reportable List for Hematopoietic Diseases.

2010
20100035 MP/H Rules/Multiple primaries--Colon: How many primaries are accessioned for a patient with two colon carcinomas in different segments of colon when there is no documentation that either tumor arose in a polyp, there is no statement indicating the presence of adenomatous polyposis coli and the resected pathology specimen indicates the presence of over 200 polyps? See Discussion.

The first MP/H rule that applies for this case is M4 [tumors in different segments of the colon]. Following rule M4, the case would be counted as two primaries and the histology would be coded per Rule H11. As these are multiple primaries, Rule H17 [Code 8220 (adenocarcinoma in adenomatous polyposis coli) when there are > 100 polyps identified in the specimen] would never apply, because H17 applies to multiple tumors abstracted as a single primary. However, Rule H17 seems to fit this case. Should Rule M3 be expanded to include a statement about > 100 polyps so these cases are not accessioned as multiple primaries?

Example: Total colectomy: 1) Distal tumor: - ulcerating moderately differentiated colonic adenocarcinoma, 3.2 cm in greatest dimension. Tumor invades through the muscularis propria into the subserosa (pt3). 2) Proximal tumor: exophytic moderately differentiated colonic adenocarcinoma, 2.9 cm in greatest dimension. Tumor invades submucosa (pt1). Multiple tubular adenomas present throughout the colon, approximate count greater than 200.

For cases diagnosed 2007 or later, use rule M3 for this case and abstract as a single primary. The case information makes it clear that this is adenomatous polyposis coli. Clarification will be added to rule M3 in the next revision of the rules. 2010
20100027 Reportability: Is AIN III reportable if it arises in the perianal skin? See Discussion. Physical exam states patient has a suspicious area of anal skin. Operative findings show a raised, suspicious lesion in the right perianal region. Our interpretation of the primary site would be skin and therefore not reportable. However, the final diagnosis on the pathology report indicates "AIN III/squamous cell carcinoma with focal areas suspicious for microinvasion. "SINQ #20041056 states that AIN III is reportable. AIN III of the anus or anal canal (C210-C211) is reportable. AIN III (8077) arising in perianal skin (C445) is not reportable. 2010
20100042

Reportability--Heme & Lymphoid Neoplasms: Given that there appears to be many differences in the reportability of these case types pre- and post-2010 (e.g., [refractory] thrombocytopenia), is there a list available that gives the reportability dates for these diseases? See Discussion.

For cases diagnosed prior to 2010 "thrombocytopenia" was not reportable. According to the Heme Database, the term "refractory thrombocytopenia" is now reportable for cases diagnosed 1/1/10 and later. It would be helpful to have a list of diagnosis date requirements for the different hematopoietic diseases.

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

Thrombocytopenia (NOS) is not reportable per Appendix F. However, the term "refractory thrombocytopenia" [9992/3] is reportable for cases diagnosed 2010 or later.

There has been no change in the reportability for thrombocytopenia. The hematopoietic "help" system lists all of the synonyms, variants, and abbreviations for diseases.

See the Hematopoietic & Lymphoid Neoplasm Coding Manual for changes in reportability associated with these cases.

 

  • Appendices D1a and D1b provide all of the new histology terms and codes.

  • Appendix D2 lists the newly reportable conditions.

    • Terms and codes in Appendix D are effective 01/01/10 and later. Refractory thrombocytopenia is included in D1a and D1b. The notes for D1a and D1b provide explanation and reiterate the dates these terms are effective.

    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
    		20100078 MP/H Rules/Histology--Lung: How is histology coded for a diagnosis of squamous carcinoma and large cell undifferentiated neuroendocrine carcinoma? For cases diagnosed 2007 or later, apply rule H7 and code the numerically higher ICD-O-3 code, 8070/3 [Squamous cell carcinoma]. See Chart 1, the histology tree in lung equivalent terms. Large cell neuroendocrine carcinoma is histology code 8013/3. The other histology is squamous carcinoma, 8070/3. 8070/3 is higher numerically than 8013/3. 2010
    		20100076 Reportability--Heme & Lymphoid Neoplasms: If not specified as primary, idiopathic, or essential, is thrombocytosis, NOS reportable?

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

    Unless the disease is specified as primary, idiopathic, essential, or the physician states there is a myeloproliferative neoplasm, the term thrombocytosis, NOS is not reportable. Thrombocytosis, NOS, is the presence of high platelet counts in the blood. Thrombocytosis can be associated with chronic infections and other diseases as well as with myeloproliferative disease. Thrombocytosis, NOS is listed in Appendix F as a Non-Reportable Term.

    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
    		20100074 Laterality--Melanoma: For a melanoma case, does the term "mid" imply that the tumor is in the midline when the site is the skin of back (trunk)? Yes. When the location is described as mid-back or mid-chest with no indication of left or right, assign laterality code 5 [midline]. 2010
    		20100024

    Histology: How is this field coded for a perivascular epithelioid cell neoplasm (PEComa) of uncertain malignant potential that is malignant based on the presence of metastases? See Discussion.

    In 11/2006 the patient had surgery for a 6cm mass in the RUQ arising in the falciform ligament. The pathologic final diagnosis was: Perivascular epithelioid cell neoplasm (PEComa) of uncertain malignant potential. In 10/2009 a liver biopsy showed metastatic perivascular epithelioid cell neoplasm.

    Assign histology code 8005/3 [malignant clear cell tumor]. According to our expert pathology consultant, this is the best histology code available at this time for the occasional tumor which is designated as malignant. The appearance of metastatic disease clearly defines this case as malignant.

    		 2010
    		20100103 Reportability--Corpus uteri: Is gestational trophoblastic neoplasia reportable if there is no mention of metastasis but the patient has been treated with chemotherapy? See Discussion.

    Per SINQ 20021106, for tumors diagnosed prior to 2007, a clinical diagnosis of metastatic gestational trophoblastic disease was to be coded to histology 9100/3 [Choriocarcinoma]. "Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma."

    		Do not report gestational trophoblastic neoplasia unless stated to be malignant. 2010
    		20100068 Histology--Heme & Lymphoid Neoplasms: How is this field coded for a JAK-2 positive myeloproliferative disorder, NOS, that is never specified as acute or chronic but was treated with Hydrea? See Discussion. The hematology oncologist referred to the case as a JAK-2 positive myeloproliferative disorder. It is never called acute or chronic. JAK-2 test was positive for mutation, and the bone marrow report indicates, "Morphological features can be seen in myeloproliferative neoplasm." Flow cytometry report indicates, "The flow data demonstrate neutrophilia with left shift. Lymphocytes are composed of a mixed population of T and B-cells with some atypical B-cells." The patient is subsequently treated with Hydrea.

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

    Code the histology to 9975/3 [myeloproliferative/myelodysplastic neoplasm, unclassifiable] which is a new code implemented in 2010. Myeloproliferative disorder NOS is equivalent to myeloproliferative disease which is listed as a synonym for code 9975/3.

    When the disease is diagnosed very early, it may manifest symptoms of two or more specific myeloproliferative neoplasms. As the disease progresses, it will manifest the symptoms of one of the specific MPN subtypes. When a more specific diagnosis becomes available, change the histology code to the more specific MPN code as directed in the PH rules. That is the scenario you describe. JAK-2 is positive, but the physician does not designate PV or ET. Hydrea is treatment for both PV and ET. In the future, the specific type of MPN may be diagnosed. In the interim, code the only diagnosis you have, MPN, NOS.

    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