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20051138 | Histology/Reportability--Hematopoietic, NOS: Is "drug induced" myelodysplastic syndrome synonymous with "therapy related" myelodysplastic syndrome? If so, would "drug induced" myelodysplastic syndome be SEER reportable and coded with the histology 9987/3? | Page 44 of the "Abstracting & Coding Guide for the Hematopoiectic Diseases" lists this histology & behavior with the proper EOD code to use but yet on page 36 it states "Do not accession the following diagnoses coded to 285.0 and lists secondary SA as well as drug-induced SA. | For cases diagnosed prior to 1/1/2010:
There is considerable difference between therapy-related myelodysplastic syndrome (MDS) and drug-induced sideroblastic anemia (SA).
Therapy-related MDS is the result of irreversible damage to the bone marrow caused by certain kinds of myelotoxic drugs used to treat cancer. Examples are Cytoxan and Etoposide. There is usually a 10+ year delay between the first primary and its treatment and the therapy-related MDS. Therapy-related MDS is not reversible and is reportable as a malignancy. Because the drugs were almost always given to treat a malignancy, therapy-related MDS is almost always a second primary.
Drug-induced SA is not reportable as a malignancy. Drug-induced SA is the result of short term effects of certain drugs on the bone marrow. Drug-induced SA is reversible, as the marrow recovers once the drugs are out of the system.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2005 |
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20031035 | Reportability/Histology--Hematopoietic, NOS: Does the presence of sideroblasts on a bone marrow biopsy confirm a diagnosis of refractory anemia with sideroblasts? | Final path diagnosis of bone marrow biopsy:
I. Hypercellular marrow for age with trilinear hyperplasia. II. Decreased iron stores with decreased sideroblasts.
Comment: Although the overall picture is not diagnostic of a specific entity, it is most consistent with an early stage myelodysplastic syndrome which would best be considered refractory anemia at this point.
In this case the percentage of sideroblasts is not stated. Would the path diagnosis of "decreased sideroblasts" along with the path comment of "refractory anemia" indicate that this case should be coded to 9982/3 [Refractory anemia with sideroblasts]? |
For cases diagnosed prior to 1/1/2010:
For the hematologic diseases, do not accession the case unless there is a definite positive diagnosis. A positive diagnosis, such as "Refractory anemia" must be stated in order to code that diagnosis. Other words associated with the positive diagnosis, such as "sideroblasts" are NOT to be used alone to assume a diagnosis.
Decreased sideroblasts does not make a diagnosis of Refractory anemia with sideroblasts. The sideroblasts for 9982/3 [Refractory anemia with sideroblasts] are characteristic in rings, and are INCREASED to make the diagnosis.
Based on the information provided, this case is not reportable. The final path diagnosis is not a reportable disease. The comment further states that the overall picture is not diagnostic of a specific entity. Therefore, it should not be reported at this point.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2003 |
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20091065 | Primary Site/CS Extension--Lymphoma: How are these fields coded for a non-Hodgkins lymphoma case with scans that show non-specific parenchymal lung nodules and a large mediastinal mass? See Discussion. |
Patient presented with large bulky mediastinal mass. CT showed no pleural effusion. Findings also show non-specific parenchymal lung nodules. Biopsy of mediastinal mass showed malignant B-cell lymphoma of follicle center cell origin. Abdomen /Pelvis CT showed borderline lymph nodes in bifurcation. Clinical diagnosis was probable stage 3 if not 4 lymphoma. Per lymphoma guidelines, if extra-nodal primary site is assigned to the extranodal site if an extra-nodal site and its regional lymph nodes are involved. Would the parenchymal lung nodules be indicative of pulmonary involvement? If so, would primary site be lung? Or, would the parenchymal nodules be stage 4 disease and primary site be assigned to lymph nodes? |
For cases diagnosed prior to 1/1/2010, this answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2. Code Primary Site to C779 [Lymph node, NOS]. In this case, there is no statement that lymphoma involves the lung. "Nonspecific parenchymal lung nodules" are not indicative of lymphoma involvement. Consequently, this cannot be assumed to be an extra-nodal lymphoma. Additionally, it is not clear whether or not the "borderline" pelvic lymph nodes are involved. If the physician cannot provide more information, follow instruction 4.e in the SEER manual on page 72. For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2009 |
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20091091 | Primary Site/CS Extension--Lymphoma: How should these fields be coded for a malignant lymphoma with spleen involvement, inguinal and iliac adenopathy, T12 lesion with bony destruction, and a paraspinal mass in lower lumbar region with extension into iliac fossa involving left psoas muscle and causing bony destruction? | For cases diagnosed prior to 1/1/2010, this answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2. Code the primary site C496 [Connective, subcutaneous and other soft tissue of trunk]. When lymphoma is present in an extranodal organ/site and in that organ/site's regional lymph nodes, code the extranodal organ/site as the primary site. In this case, there is a soft tissue paraspinal mass at T12 extending into iliac fossa, left psoas muscle and bone. Lymph nodes are also involved. Assign CS extension code 21 [Direct extension to adjacent organs or tissues].
For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2009 | |
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20091026 | CS Extension--Extramedullary Plasmacytoma: Under what circumstance would CS extension code 80 be used in a case of extramedullary plasmacytoma? | For cases diagnosed prior to 1/1/2010, this answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
Assign CS extension code 80 [Systemic disease] for extramedullary plasmacytoma involving more than one site. Use code 80 when extramedullary plasmacytoma is NOT single, solitary, unifocal, isolated, mono-ostotic or localized. Code 80 can also be used when the bone marrow is involved but the plasma cells are <10%. Do not apply EOD instructions to CS.
For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2009 | |
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20230005 | SEER Manual/First Course Treatment--Radiation Treatment Modality: How is Peptide Receptor Radionuclide Therapy (PRRT), a form of molecular therapy, coded when used to treat neuroendocrine tumors? See Discussion. |
The 2023 SEER Manual indicates PRRT should be coded in the Other Therapy field per coding instruction 2.d. Likewise, SINQ 20180106 instructs to code PRRT as Other Therapy, while the discussion portion clearly outlines the radioactive nature of this modality. Would PRRT be best coded as a radioisotope in the Radiation Treatment Modality--Phase I, II, III field rather than in the Other Therapy field? |
For cases diagnosed in 2023 and later, Update to the current manual: Assign code 13 (Radioisotopes, NOS) in Radiation Treatment Modality--Phase I, II, III for PRRT. We will make this change in the next version of the SEER Manual. |
2023 |
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20021079 | Primary Site/Histology (Pre-2007)/EOD Fields/Surgery of Primary Site--Abdomen, NOS: What codes are used to represent these fields for a case with a resection of the rectosigmoid and adjacent tumor mass that demonstrated no tumor in the rectosigmoid but extramural to the colon there was an endometrioid adenocarcinoma arising in association with an area of endometriosis (possibly within the pericolic soft tissue or in an ovarian remnant)? | For cases diagnosed in 2003, code to: Primary Site: C76.2 [abdomen, NOS] Histology: 8380/3 [Endometrioid adenocarcinoma] EOD size, extension, lymph node: 999, 99, 9 [Unknown] Surgery of Primary Site: 98 [All unknown and ill-defined disease sites, WITH or WITHOUT surgical treatment] Scope of Regional LN Surgery: 0 [None] Surgical Procedure of Other Site: 2 [Non-primary surgical procedure to other regional sites]. |
2002 | |
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20010095 | EOD-Extension--Lung: Are "aortico-pulmonary window", "paratracheal space", and "subcarina" coded in the EOD extension field or in the EOD lymph node involvement field? See discussion. | Would a lung tumor that extends into the AP window be synonymous with extension into the mediastinum? If so, would this also apply to extension to subcarina, paratracheal space, and other such terms corresponding to areas listed in the mediastinal lymph node field under code 2? | For cases diagnosed between 1998-2003:
Extension into the aortico-pulmonary window, would be coded in the EOD-Extension field as 70 [mediastinal extension]. If the tumor extends into the paratracheal space, subcarina, or other areas listed under the code 2 in lymph nodes, code the EOD-Extension field to 70 to capture this type of involvement. |
2001 |
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20010084 | EOD-Size of Primary Tumor: Can you code the known size of the residual tumor in a further resected specimen if the size of the tumor in a prior excisional biopsy is unknown? See discussion. | Excisional biopsy is done prior to admission and the tumor size is unknown. Pt is admitted for a mastectomy and the residual tumor size is 5 mm. | For cases diagnosed between 1998-2003:
Code the EOD-Size of Primary Tumor field to 999 [unknown]. The majority of the tumor would have been removed during excisional biopsy and it is possible that the tumor could have been quite large. |
2001 |
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20010002 | EOD-Size of Primary Tumor: How do you code tumor size for lesions described as "at least 2 cm"? See discussion. | The expression "at least 2 cm" seems to be different from "greater than 2 cm." Stating "at least" seems to indicate that if the tumor is larger than 2 cm, it is difficult to ascertain the exact tumor size. Should we accept 2 cm as the best info we have, or default to 999 because of the lack of specificity? | For cases diagnosed between 1998-2003:
Code the EOD-Size of Primary Tumor field to 020 [2 cm], using the rule "code what you know." |
2001 |
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