Reportability--Corpus uteri: Is endometrial atypical complex hyperplasia/borderline endometrial adenocarcinoma (FIGO 1), (mucinous type), (no invasion of myometrium) reportable?
Do not report this case based on the information provided. The actual diagnosis is somewhere between atypical hyerpplasia and carcinoma in situ. Do not report until/unless a more definitively reportable diagnosis is made.
Measured Thickness/EOD-Extension--Melanoma: If the Clark's level is not provided, can it be estimated using the depth of invasion provided in the pathology report and associating that number with the Clark's levels identified in the SEER Summary Staging Guide?
For cases diagnosed 1998-2003:
No. Do not use the SEER Summary Stage Guide or any other guide to derive an estimated Clark's level from the thickness identified in the pathology report. The two measurements need to come directly from the pathology report. Each is coded separately in EOD. Thickness is collected in a separate field so we can capture the actual measurement stated in the pathology report. This has made it possible for us to group depth of invasion for analysis purposes in any manner we might wish. In addition, we can always collapse this information to the Summary Stage or TNM using the AJCC rules. AJCC rules use both depth of invasion and thickness in determining pathologic staging, and, if there is an inconsistency between them, the rules say code to the higher T classification, that is, the least favorable finding.
Grade, Differentiation: Are anaplastic tumors always coded to grade 4, even for anaplastic brain primaries?
Yes. Always code the Grade, Differentiation field to for 4 [Grade IV] for "anaplastic" tumors. Anaplastic is synonymous with undifferentiated. Refer to the example in the SEER Program Code Manual, 3rd Ed.
First Course Treatment/Neoadjuvant Treatment: How is Neoadjuvant Therapy--Clinical Response (NAACCR #1633) coded if a physician documents excellent response to treatment and nothing further?
Clarify the statement of "excellent" with the managing physician if possible. If no further information can be obtained, assign code 8 in Neoadjuvant Therapy–Clinical Response and document the details in text fields.
MP/H Rules/Histology--Prostate: If a patient is stated to have prostate "cancer" but a pathology report is not available nor is a specific histology stated in the medical record, can this histology be coded to 8140 [adenocarcinoma] instead of 8000/3 [cancer] because the vast majority of prostate cancers are adenocarcinomas?
For cases diagnosed 2007 and later, the correct histology code is 8000/3 [cancer]. The steps used to arrive at this decision are:
Open the Multiple Primary and Histology Coding Rules Manual. Choose one of the three formats (i.e., flowchart, matrix or text). Go to the Other Sites Histology rules because no specific rules have been developed for prostate primaries.
To determine the histology, start at the SINGLE TUMOR: INVASIVE ONLY module, rule H8. The rules are intended to be reviewed in consecutive order within a module. Code the histology documented by the physician when there is no pathology/cytology specimen or the pathology/cytology report is not available. Code the histology as 8000/3 [cancer] because that is the only available information. In the absence of a pathology report or any other histologic confirmation, code the histology based on the information available.
Surgery of Primary Site/Date Therapy Initiated--Cervix: Should "negative endocervical curettings" be coded as surgical treatment for carcinoma in situ of the cervix primaries and should the date of the procedure ever be used in coding the Date Therapy Initiated field?
For cases diagnosed 1/1/2003 and later: Code Surgery of Primary Site to 25 [D&C endocervical curettage (for in situ only)]. If this is the first treatment given, the Date Therapy Initiated is coded to the date of the curettage.
Histology (Pre-2007)--Melanoma: How is histology coded for a final pathology diagnosis of "malignant melanoma, NOS" that is clinically described as a nevus?
For tumors diagnosed prior to 2007:
Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].
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.
EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: What codes are used to represent these fields when only a regional lymph node (positive) aspiration is performed?
For cases diagnosed 1998-2003:
With the exception of those sites/histologies that require 99 in these fields, code the Number of Regional Lymph Nodes Positive field to 97 [Positive nodes but number of positive nodes not specified]. Code the Number of Regional Lymph nodes Examined field to 95 [No regional Lymph nodes removed, but aspiration of regional Lymph nodes was performed].
Reportability--Lung: Is sclerosing hemangioma of the lung with multiple regional lymph nodes metastases reportable?
No, it is not reportable. According to the WHO Classification of Lung Tumours, sclerosing hemangioma "behaves in a clinically benign fashion...Reported cases with hilar or mediastinal lymph node involvement do not have a worse prognosis."
An official website of the United States government
Home