First Course Treatment/Surgical Margins of the Primary Site--Melanoma: Is margin status positive or negative when the lesion “approximates” margins? This was noted in the pathology report comment on a malignant melanoma in-situ shave biopsy. Follow-up with physicians is not possible in this situation.
Assign margin status as “positive” when stated as approximates margins as recommended by our expert pathologists. Approximating means coming right up to inked margin without the margin transecting the tumor.
Histology (Pre-2007)--Ovary: What codes are used to represent "mixed papillary serous and clear cell carcinoma" and "papillary serous carcinoma with focal clear cell features" of the ovary?
For tumors diagnosed prior to 2007:
Assign code 8323 [Mixed cell adenocarcinoma] to "mixed papillary serous and clear cell carcinoma." This is histology coding rule 3 in the 2004 SEER manual under single tumor (page 86). There is no other code for this mixture.
Example 1: 8323
Example 2: 8461 (clear cell is not coded according to Rule 6, page 87, because it is not the majority of the 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.
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.
Primary Site--Breast: What subsite code should be used for a diagnosis of "inflammatory carcinoma"?
Code the Primary Site field to C50.9 [Breast, NOS] for a breast primary presenting with inflammatory cancer unless there is a palpable mass within the breast. If there is a palpable mass, code the primary site to the position of the mass.
Histology (Pre-2007)--Prostate: What code is used to represent the histology "adenocarcinoma, cribriform type"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8201/3 [cribriform carcinoma]. The word "type" is a term that indicates majority of the tumor. The term "cribriform" would be a term used to determine the histology code.
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.
Surgery of Primary Site--Breast: How is this field coded when a re-excision follows a prior mastectomy?
Code the most extensive surgery in Surgery of Primary Site. This is a cumulative field. Assign the appropriate code including all surgeries of the primary site performed during the first course of treatment.
The correct code for mastectomy followed by re-excision will depend on the extent of the re-excision. For example, if the re-excision removed muscle, code radical mastectomy.
MP/H Rules/Histology--Colon: How is histology coded when the final pathology diagnosis is "adenocarcinoma with extensive mucinous features" and the percent of mucinous features is not stated?
Code 8140 using rule H6. Rule H6 applies because the percent of mucinous is not specified.
CS Extension/Histology (Pre-2007)--Breast: Paget disease with underlying DCIS. How should CS Extension, SEER Summary Stage 2000, histology, and behavior be coded?
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.
For tumors diagnosed prior to 2007:
Based only on the information provided above,
1. The CS extension code is 07 [Paget disease of nipple (without underlying invasive carcinoma pathologically)].
2. The SS 2000 stage is 1 [Localized].
3. The histology code is 8543 [Paget disease and intraductal carcinoma of breast]. The behavior code is 3 [Malignant].
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].
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