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Report Produced: 06/18/2026 00:03 AM

Report Question ID Question Discussion Answer Year
20210045

Update to Current Manual/Neoadjuvant Treatment: What codes should be used for Neoadjuvant Therapy--Clinical Response and Neoadjuvant Therapy--Treatment Effect when the neoadjuvant therapy is still in progress at the time the case is initially abstracted as with rapid reporting. There is no code for neoadjuvant therapy still in progress and code 9 generates an edit for Neoadjuvant Therapy--Clinical Response.

Assign code 8 for Neoadjuvant Therapy--Clinical Response and assign a code 9 for Neoadjuvant Therapy--Treatment Effect when the treatment is still in progress. Revise these codes after the treatment has been completed.

We will update the manual to include these instructions.

 2021
20081095 Race, ethnicity/Spanish surname or origin: If birthplace is Brazil or Portugal, patient's last name is on the Spanish Surname list, and there is no text to further clarify ethnicity, what is the correct Spanish Ethnicity code: 0 or 7? See Discussion. See also SINQ 20081075.

Assign code 7 [Spanish surname only] when the last name is on the Spanish Surname list. This includes cases for which the birthplace is Brazil, Portugal or the Philippines and there is no text to further clarify ethnicity.

The instruction to use code 0 [Non-Spanish/Non-Hispanic] in the SEER manual on page 51 (#2) applies when the only information available is the birthplace or a statement of "Portuguese," "Brazilian" or "Filipino."

 2008
20240042

EOD 2018/EOD Primary Tumor--Cervix: How is Extent of Disease (EOD) Primary Tumor of the cervix coded when it invades into the bladder on surgery and noted as T4. No further information is provided, and it is not possible to contact the physician for clarification. Would you code 550 (Bladder wall; bladder, NOS excluding mucosa), 750 (Bladder mucosa), or 999 Unknown?

Assign code 550 (Bladder, NOS excluding mucosa) to EOD Primary Site based on invasion into the bladder with no mention of mucosa. EOD Primary Tumor for cervix, Note 1, instructions are to use the extension information to code primary tumor in preference to a statement of FIGO stage when both are available. TNM staging is closely related to FIGO stage, and the surgical findings of bladder invasion NOS in this case should be used in preference to the statement of T4.

 2024
20071120 Surgery of Primary Site--Breast: Should code 51 (Modified radical mastectomy without removal of uninvolved contralateral breast) be used when a patient has excisional biopsy (22) and axillary dissection followed by a simple mastectomy without removal of uninvolved contralateral breast (41) as part of the first course of treatment?

Assign code 51 or 52 if a patient has an excisional biopsy and axillary dissection followed by a simple mastectomy during the first course of therapy. Code the cumulative result of the surgeries, which is a modified radical mastectomy in this case.

SEER collects only one surgery code per case. Code the most invasive, extensive or definitive surgery in Surgery of Primary Site.

 2007
20170079

Surgery of Primary Site--Corpus Uteri: Is surgery for a uterine corpus primary described as total abdominal hysterectomy-bilateral salpingo-oophorectomy (TAH-BSO) with specimens including uterine corpus, cervix, bilateral ovaries and fallopian tubes, and bilateral parametria coded as a modified radical hysterectomy? It would be very helpful if an explanation of the difference between a total hysterectomy, modified radical hysterectomy, and radical hysterectomy can be included. See Discussion.

Surgery text indicates TAH-BSO with bilateral pelvic and paraaortic lymph node dissection. The pathology report indicates the specimen includes: Uterine corpus, cervix, bilateral ovaries and fallopian tubes, bilateral parametria. The Gross Description also indicates: Representative sections submitted in 16 cassettes as follows: A1: Anterior cervix A2: Posterior cervix A3: Full thickness anterior lower uterine segment A4: Full thickness posterior lower uterine segment A5: Tumor A6-A7: Full thickness anterior endomyometrium to include tumor A8-A10: Full thickness posterior endomyometrium with tumor A11: Representative sections of right fallopian tube and fimbria A12: Representative sections of right ovary A13: Representative sections of left fallopian tube and fimbria A14: Representative sections of left ovary A15: Right parametrial tissue A16: Left parametrial tissue A17-23: Remainder of cervix.

Assign code 50: total hysterectomy with removal of tube(s) and/or ovary(ies). Removes both the corpus and cervix uteri. It may also include a portion of the vaginal cuff. Both the radical and modified radical hysterectomy (code 60) include removal of part of the vagina, not mentioned in the pathology or surgery text.

The SEER Glossary for Registrars defines the procedures as follows.

Total hysterectomy: Surgery to remove the entire uterus, including the cervix

Radical hysterectomy: Surgery to remove the uterus, cervix and part of the vagina. The ovaries, fallopian tubes and nearby lymph nodes may also be removed.

Modified radical hysterectomy: Surgery to remove the uterus, cervix, upper part of the vagina, and nearby ligaments and tissues. Nearby lymph nodes may also be removed. In this type of surgery, not as many tissues and/or organs are removed as in a radical hysterectomy.

https://seer.cancer.gov/seertools/glossary/

 2017
20170055

First Course of Treatment/Surgery of Primary Site--Corpus uteri: Do you code total hysterectomy or radical hysterectomy when a specimen indicates the uterus, cervix, ovaries, fallopian tubes, and right and left parametrium were resected, but shows no portion of the vagina. See Discussion.

AFS1-AFS2-frozen section control, endomyometrium; AFS3-frozen section control, subserosal intramural mass; A4-anterior cervix; A5-posterior cervix; A6-anterior cervical endometrial junction; A7-posterior cervical endometrial junction; A8-A10-anterior endomyometrium, including tumor; A11-A13-posterior endomyometrium, including tumor and adjacent mass; A14-random section subserosal mass; A15-left parametrium at margin of resection; A16-right parametrium at margin of resection; A17-A18-left ovary and fallopian tube; A19-A20-right ovary and fallopian tube. The final diagnosis includes Endometrial adenocarcinoma, favor serous carcinoma, with papillary and solid areas. Tumor involves: Cervix present, Right ovary, Left ovary, Right fallopian tube, Left fallopian tube, Right parametrium, Left parametrium.

Assign code 50 for total hysterectomy. According to Appendix C Surgery Codes for Corpus Uteri of the 2016 SEER Coding and Staging Manual, total hysterectomy is surgery to remove the entire uterus, including the cervix; whereas, radical hysterectomy includes the vagina.

 2017
20140025

Grade--Heme & Lymphoid Neoplasms: Why isn't "T-cell granular lymphocytic leukemia" (9831/3) coded as "5 T-cell" instead of "9" as specified in the Heme database? My path department did not specify any type of grade, but since "T-cell" is part of the name, wouldn't you code it to "5"?

Assign code 5 when the diagnosis on the pathology report specifies "T-cell granular lymphocytic leukemia." The Heme DB grade instruction states "Code grade specified by pathologist. If no grade specified, code 9." In this case, T-cell was specified - code it. The code for T-cell (5) was not automatically assigned in the Heme DB because of the alternate names for this neoplasm. Some of these include NK-cell. Assign code 8 for alternate names with NK.

The alternate names are: Chronic lymphoproliferative disorder of NK cells, Chronic NK-cell lymphocytosis, Chronic NK-large granular lymphocyte (LGL) lymphoproliferative disorder, CLPD-NK, Indolent large granular NK-cell lymphoproliferative disorder, NK-cell lineage granular lymphocyte proliferative disorder, NK-cell LGL lymphocytosis

2014
20170034

Surgery of Primary Site--Breast: Would you code a unilateral breast simple mastectomy with tissue expanders and AlloDerm or an acellular dermal matrix as Code 45, Reconstruction with Implant, or Code 46, Reconstruction with Combined Tissue and Implant? See Discussion.

Since acellular dermal matrix/AlloDerm comes from human tissue donors with cells removed and sterilized to promote regenesis and decrease rejection, is Alloderm coded as "Tissue' as it also "provides an additional layer of tissue between the skin and the implant?

Assign code 43 for a simple mastectomy with tissue expanders and acellular dermal matrix/AlloDerm. The tissue expander indicates preparation for reconstruction. The acellular dermal matrix/AlloDerm is not coded because, while they often accompany an implant procedure, they are not the principle element of reconstructive procedures. The principle elements would be tissue from the patient and/or prosthetics (e.g., gel implants).

 2017
20160007

Surgery of Primary Site--Breast: If the diagnosis is a single primary involving both breasts, do we code 41 Surgery Primary site with 1 in Surgery Other site, or code 76 Surgery Primary site with 0 in Surgery Other site? See discussion.

In Appendix C- Breast (SEER Manual 2015) it states under the codes for TOTAL MASTECTOMY (Codes 40-49, 75): For single primaries only, code removal of involved contralateral breast under the data item Surgical Procedure/Other Site (NAACCR Item # 1294). [SEER Note: Example of single primary with removal of involved contralateral breast--Inflammatory carcinoma involving both breasts. Bilateral simple mastectomies. Code Surgery of Primary Site 41 and code Surgical Procedure of Other Site 1.] HOWEVER, underneath that it states code 76 is used for: 76 Bilateral mastectomy for a single tumor involving both breasts, as for bilateral inflammatory carcinoma. So

Assign code 41 with 1 in surgery other site for simple mastectomy. Assign code 76 with 0 in surgery other site for a more extensive mastectomy.

2016
20200026

EOD 2018/EOD Primary Tumor--Lung: How should EOD Primary Tumor be coded when imaging describes a large left upper lobe 9.1 cm mass that Also noted is no pleural effusion and normal chest wall. See Discussion.

It is unclear if code 300 is appropriate, since technically the fissure is comprised of pleura, involvement of the fissure appears to imply a tumor that is no longer localized.

An argument could be made for code 400, since the term traverses could be interpreted as crossing into adjacent lobe, however the lower lobe is not mentioned in this scan.

Assign code 400 as the term "traverses" indicates involvement with extension to the major fissure and is no longer confined to the left lobe.

 2020