| Report | Question ID | Question | Discussion | Answer | Year |
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20010104 | Date of Diagnosis--Lung: Based on Note 7 in the lung EOD, should the Date of Diagnosis field be coded to an earlier CT scan date with a reported diagnosis of "RUL mass with mediastinal lymphadenopathy" or to the later biopsy date with a reported diagnosis of small cell carcinoma? See discussion. | Note 7 states that "mediastinal lymphadenopathy" indicates involved lymph nodes for lung primaries. Should the date of diagnosis be back-dated to the date of the scan? | For cases diagnosed 1998-2003:
No, code the Date of Diagnosis field to the later biopsy date. Note 7 is intended for use in coding the EOD-Extension field, not the Date of Diagnosis field. The earlier scan has a diagnosis of RUL "mass" not a "malignancy" so the fact that there is mediastinal lymphadenopathy mentioned in that scan is not used to help determine date of diagnosis. |
2001 |
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20010143 | EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Lung: How do you code these fields for clinically positive lymph nodes when the result of neoadjuvant treatment is that the lymph nodes are pathologically negative? See discussion. | The pt presents with "mediastinal adenopathy" for a lung primary and was treated with pre-operative radiation therapy. After two months, he was treated with surgery. The 10 lymph nodes removed were all negative. How does SEER code these three EOD fields?
Will an error be triggered in SEER Edits if you code lymph nodes as clinically positive in the EOD lymph node involvement field and yet pathologically negative in the number of regional nodes positive and number of regional nodes examined fields? |
For cases diagnosed 1998-2003:
Code the EOD-Lymph Nodes field to 2 [Mediastinal, NOS]. Code the EOD-Regional Lymph Nodes Positive and Examined fields to 00/10. You will not have a problem with the SEER Edits. The EOD field is coded using clinical and pathologic information. All information gathered within four months of the date of diagnosis (in the absence of disease progression) or through completion of surgery(ies) can be used to code EOD. The clinically positive nodes justify the radiation therapy. |
2001 |
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20010158 | EOD-Pathologic Extension--Prostate: Does capsular invasion (code 32) take priority over apex extension (code 34) on prostate primaries? See discussion. | On prostatectomy, adenocarcinoma involves left apex and also left mid lobe where it focally invades capsule. Do we code extension to 34 - the highest numerical code, or to 32 to capture the capsular invasion? Do codes 33 and 34 represent a subset of code 31, and would code 32 represent greater tumor involvement? | For cases diagnosed 1998-2003:
Code the EOD-Pathologic Extension field to 32 [Invasion into (but not beyond)prostatic capsule] when there is both capsular and apex invasion of the prostate.
Although numerically lower, code 32 takes precedence over codes 33 [arising in the apex] and 34 [extending to the apex]. Codes 33 and 34 are "subsets" of code 31 [Into prostatic apex/arising in prostatic apex]. |
2001 |
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20010103 | Histology (Pre-2007)--Breast: Are diagnoses of "infiltrating duct and mucinous carcinoma" and "duct carcinoma, mucinous type" both coded to the histology code of 8523/3? | For tumors diagnosed prior to 2007:
Code "Infiltrating duct and mucinous carcinoma" to 8523/3 [Infiltrating duct mixed with other types of carcinoma] according to the instructions for coding a single tumor with complex histology in Appendix C of the 2004 SEER manual. Assign code 8523/3 when the diagnosis is duct carcinoma mixed with another type of carcinoma. Look for "and" or "mixed" in the diagnosis. Code the Histology field for a "ductal carcinoma, mucinous type" to 8480/3 [Mucinous carcinoma]. The instructions for coding a single tumor with complex histology are to code the specific type if the diagnosis is "Duct carcinoma, _____ type."
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. |
2001 | |
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20010070 | EOD Lymph Nodes--Colon/Rectum: How do you code "mesocolic lymph nodes" for colorectal primaries? | For cases diagnosed between 1998-2003:
Code the EOD-Lymph Nodes field to 3 [Mesenteric, NOS]. Mesocolic lymph nodes are coded as mesenteric lymph nodes. |
2001 | |
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20010129 | Histology (Pre-2007)--Breast: What code is used to represent the histology "duct carcinoma, colloid type"? See discussion. | Do we use 8480/3 [colloid carcinoma] or 8523/3 [duct carcinoma] mixed with other types of carcinomas? | For tumors diagnosed prior to 2007:
Code the Histology field to 8480/3 [colloid carcinoma] per Rule 4. The lesion is colloid type of ductal carcinoma, not ductal carcinoma mixed with colloid carcinoma.
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. |
2001 |
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20010075 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma with a mucinous focus"? See discussion. | Could 8480/3 [mucinous adenocarcinoma] be used to code histology? | For tumors diagnosed prior to 2007:
Code the Histology field to 8140/3 [adenocarcinoma, NOS]. "Focus" does not indicate the majority of tumor per rule C2 on page 2 of the Coding Complex Morph Dx's. The tumor must be at least 50% mucinous, mucin producing, or signet ring to be coded to the specific histology.
We code to the more specific term if there are no qualifying or modifying terms such as: focally, focus, predominantly. If any qualifying words are used, the C1 rule applies, which is to code to the majority of tumor.
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. |
2001 |
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20010164 | EOD-Size of Primary Tumor--Prostate: If you only have a biopsy and not a resection of the primary site, can you code the size of the prostate nodule demonstrated on digital rectal exam? See discussion. | Example 1: Digital rectal exam reveals 1 cm left side prostate nodule. TRUS-guided biopsy of left side of prostate shows adenocarcinoma. Right side biopsy is negative. Is size coded to 010 or 999?
Example 2: Digital rectal exam reveals 1 cm left side prostate nodule. Bone scan was positive for metastatic disease. Is size coded to 010 or 999? |
For cases diagnosed 1998-2003:
You need path confirmation that a malignancy exists in the prostate before you can code the size of the nodule seen clinically.
Example 1: Code the EOD-Size of Primary Tumor to 010 [1 cm], because the nodule in the prostate is confirmed as cancer by needle biopsy.
Example 2: Code the EOD-Size of Primary Tumor to 999 because there was no pathologic confirmation of malignancy. |
2001 |
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20010012 | Surgery of Primary Site--Breast: What code is used to represent this field for a breast primary treated with a "bilateral mastectomy"? See discussion. |
Pt diagnosed with rt breast primary opted to be treated with rt modified radical mastectomy and lt simple mastectomy. Path revealed invasive ductal carcinoma on the rt and ductal carcinoma in situ on the lt. Path reported 14 axillary lymph nodes were found in the mastectomy specimen. |
There are two primaries. For cases diagnosed 1/1/2003 and after: For the rt breast, code Surgery of Primary Site to 51. The contralateral left breast malignancy is not involved with the right breast primary by either direct extension or metastasis. Codes 42 and 52 are used to capture prophylactic mastectomy of the opposite noncancerous breast. In this case, the opposite breast has cancer so these codes cannot be used. Code Scope of Regional Lymph Node Surgery to 5 and Surgical Procedure of Other Site to 0. For the lt breast, code Surgery of Primary Site to 41, Scope of Reg LN Surgery to 0, and Surgical Procedure of Other Site to 0. |
2001 |
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20010091 | Surgical Procedure of Other Site: Is the excision of a distant lymph node or a fine needle aspirate (FNA) of a distant lymph node coded as a Surgical Procedure of Other Site, even though they are performed for diagnostic purposes and not intended as treatment? | 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. |
2001 |
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