EOD 2018/EOD Primary Tumor--Melanoma: The code and level translations in the Note 4 of Extent of Disease (EOD) Primary Tumor for Melanoma Skin seem incorrect. Please advise.
* Code 000: In situ
* Code 100: Level I (should be level II) (< 0.75 mm Breslow's Depth)
* Code 200: Level II (should be level III) (0.76 mm to 1.50 mm Breslow's Depth)
* Code 300: Level III (should be level IV) (> 1.50 mm Breslow's Depth)
Please see the corrected levels below for the note. Note 4: If a Breslow's depth is given in the pathology report and there is no other indication of involvement, the following guidelines may be used (Note: If a physician documents a different Clark's Level than provided by these guidelines, go with the physician's Clark Level)
Code 000: Level I (In situ)
Code 100: Level II (< 0.75 mm Breslow's Depth)
Code 200: Level III (0.76 mm to 1.50 mm Breslow's Depth)
Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be abstracted when a patient is simultaneously diagnosed with multiple myeloma/plasma cell myeloma, plasmacytoma and plasma cell leukemia?
This is accessioned as one primary and the histology is coded to 9732/3 [multiple myeloma].
To arrive at this answer, it is important to first try to determine how many different unique neoplasms there are to correctly identify the number of primaries to report. Per the Heme DB, plasma cell leukemia is an obsolete term. The current term and histology code for this diagnosis is 9732/3 [plasma cell myeloma]. Plasma cell myeloma and multiple myeloma are synonyms per the Heme DB. Therefore, per Rule M2 a single primary exists when there is a single histology. That takes care of the multiple myeloma/plasma cell myeloma and plasma cell leukemia, but not the plasmacytoma.
In checking the Heme DB, the terms plasma cell myeloma and multiple myeloma are not synonyms for plasmacytoma. Therefore, we are left to determine whether the multiple myeloma/plasma cell myeloma vs the plasmacytoma represents one or two primaries.
Under the Transformation section of the Heme DB, it indicates that plasmacytoma (a chronic disease process) transforms to multiple myeloma (an acute disease process). Per Rule M9, abstract a single primary and code the acute histology when both a chronic and an acute neoplasm are diagnosed simultaneously. The histology is coded to the acute neoplasm when there is no information on the biopsy regarding which is the "later" histology. This update will be added to the Heme Manual.
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.
2021 SEER Manual/Surgery of Primary Site--Lung: What is the correct surgery code for a left upper lobe (LUL) wedge resection (confirming adenocarcinoma) followed by a lingular-sparing LUL lobectomy and mediastinal lymph node dissection? Is the correct Surgery Code 22 since the lingula was not resected (not the whole LUL Lung)? Or should the appropriate surgery code be 33 (this surgery suffices to code to a lobectomy with the mediastinal lymph node dissection)?
Assign code 22 for LUL wedge resection followed by a lingular-sparing LUL lobectomy and mediastinal lymph node dissection. Code the lymph node surgery in Scope of Regional Lymph Node Surgery. We obtained input from an expert who agrees with this code. He states a lingula-sparing lobectomy is best coded as a segmentectomy because it is the same as an apical trisegmentectomy.
EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?
For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.
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?
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.
Histology (Pre-2007)--Kidney: Is 8316/3 [Cyst associated renal cell carcinoma] the appropriate code for 1) Cystic renal cell carcinoma, 2) Renal cell carcinoma mass with cystic areas and 3) Cystic renal cell carcinoma, clear cell type?
For tumors diagnosed prior to 2007:
Yes, ICD-O-3 histology code 8316 is the correct code for the three examples above.
There are two categories of cyst-associated renal cell carcinomas: Renal cell carcinoma originating in a cyst, and Cystic renal cell 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.
Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])?
For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS].
Histology (Pre-2007)--Breast: What code is used to represent histology for "invasive ductal carcinoma with squamous differentiation"? Is "squamous differentiation" synonymous with "squamous metaplasia"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8570/3 [Adenocarcinoma with squamous metaplasia]. Our pathology consultant agrees that squamous metaplasia is synonymous with squamous differentiation.
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.
An official website of the United States government
Home