Histology (Pre-2007)/Diagnostic Confirmation: What code is used to represent the histology that initially presents on uterine curettage as a hydatidiform mole and after pulmonary metastases develop a month later, the clinical diagnosis is "metastatic gestational trophoblastic disease"?
For tumors diagnosed prior to 2007:
Code the Histology field to 9100/3 [Choriocarcinoma]. Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma.
Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only] based on the information above. However, if imaging, direct visualization, or another method identified the pulmonary metastases, then code the Diagnostic Confirmation accordingly.
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.
First Course Treatment/Surgery of Primary Site--Breast: How is "Goldilocks," also referred to as oncoplastic reconstruction, in the surgery section for breast cancer patients coded?
Code Goldilocks mastectomy in Surgery of Primary Site. Breast surgery code 30 seems to be the best available choice for "Goldilocks" mastectomy. It is essentially a skin-sparing mastectomy with breast reconstruction. The choice between code 30 and codes in the 40-49 range depends on the extent of the breast removal. Review the operative report carefully and assign the code the best reflects the extent of the breast removal.
Behavior Code/EOD-Extension--Colon: Are extension codes 10 [Mucosa, NOS (incl. Intramucosal, NOS)] and 11 [Lamina propria] in situ, in accordance with AJCC stage for this site?
For cases diagnosed 1998-2003: EOD codes 10 and 11 are invasive. SEER, to be compatible with Summary Stage 77 and 2000, calls EOD extension codes 10 and 11 invasive because invasion of the lamina propria is invasion through the lamina propria/basement membrane and therefore invasive.
According to AJCC, the survivial rates for tumors that invade only the mucosa or lamina propria are similar to Tis tumors, so the AJCC classifies them as Tis.
Histology--Lymphoma: How is a "lymphocytic lymphoma of follicular center cell origin" coded?
For cases diagnosed prior to 1/1/2010:Assign code 9690 [Follicular lymphoma, NOS]. According to the WHO Classification of Lymphoid tumors, follicular lymphoma is a neoplasm of follicle center B cells which has at least a partially follicular pattern.
Assign code 9695 for follicular lymphoma grade 1, 9691 for follicular lymphoma grade 2, and 9698 for follicular lymphoma grade 3.
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.
First Course of Treatment/Other Therapy: Where do you code Optune TTF therapy? What needs to be included in the text portion to document this treatment?
If OPTUNE was administered for recurrence, be sure NOT to record it in the first course of treatment fields. Check with CoC if you have questions about coding treatment for recurrence.
Solid Tumor Rules (2018)/Histology--Lung: What is the histology code of a 2018 lung case whose pathology states adenocarcinoma, acinar predominant?
The Solid Tumor Rules for Lung rule H4 applies. Per Table 3, page 12, third column on adenocarcinoma row, adenocarcinoma, acinar predominant is coded to 8551/3.
EOD-Extension--Lung: How do you code extension for a lung tumor described on bronchoscopy as "obstructing the RUL and intruding into the right bronchus intermedius. Small tumor nodules distally in midline of anterior trachea wall"?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 85 [Metastasis] because the tumor nodules are discontinuous from the primary tumor.
Surgery of Primary Site--Ovary: How should this field be coded for an ovarian primary when there is a BSO and only the fundus of uterus is removed (not a full hysterectomy)?
Assign surgery code 52 [Bilateral (salpingo-) oophorectomy; WITH hysterectomy]. Code 52 does not exclude a partial hysterectomy.
Behavior Code--Bladder/Lymphoma: Should the "in situ" designation on a bladder primary's pathology report be ignored that states a diagnosis of "in situ lymphoma"?
Ignore the in situ designation. You cannot assign an in situ behavior code to a lymphoma primary. The term or designation of "in situ" is limited to solid tumors; carcinoma and/or cancer.