Histology (Pre-2007): What code is used to represent the histology if the final diagnosis between an electron microscopy report and the immunocytochemistry (ICC) differs and both histologies are specific (e.g., one report states papillary carcinoma and the other states squamous cell carcinoma)?
For tumors diagnosed prior to 2007:
There is no established hierarchy between electron microscopy and ICC findings. Contact the pathologists involved in these types of cases to determine the final histologic diagnosis.
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-Lymph Nodes--Lung: Are positive "neck nodes" coded to 7 [Distant lymph nodes, other than above (including cervical lymph nodes)] in this field because we do not have a specific lymph node chain named or are they coded to 6 [Contra lateral hilar or mediastinal (incl. bilateral); supraclavicular (transverse cervical), ipsilateral or contralateral; scalene, ipsilateral or contralateral] because this code represents the lowest possible code for involved neck nodes?
For cases diagnosed 1998-2003: Code EOD-Lymph Nodes as 7 [Distant lymph nodes, other than above (incl. cervical neck nodes)]. Lymph nodes in the "neck" are distant, rather than regional, for lung.
Grade/Neuroblastoma: What grade is to be used when pathology states only differentiating retroperitoneal neuroblastoma?
For cases diagnosed prior to 2018
Assign grade code 2 for "differentiating" retroperitoneal neuroblastoma. The rationale of our expert pathologist advisor is that "it leaves the grade 1 category open (since a "well differentiated neuroblastoma" is actually called ganglioneuroblastoma), and it also avoids putting "differentiating" into what is usually a well differentiated category."
Additionally, assign grade code 3 to a poorly differentiated retroperitoneal neuroblastoma and grade code 4 to an undifferentiated retroperitoneal neuroblastoma.
For cases diagnosed 2018 and later
Follow the instructions for coding grade in SEER*RSA
Reportability/In Situ--Prostate: Was there a time period when PIN III was reportable to SEER?
Per the 2004 SEER Manual, page 2, Reportable Diagnoses, Exceptions, 1.b.iii "Prostatic intraepithelial neoplasia (PIN III) of the prostate (C619). (Collection stopped effective with cases diagnosed 1/1/2001 and later.)"
MP/H Rules/Histology--Ovary: How is histology coded for "serous carcinoma, papillary invasive pattern"?
For cases diagnosed 2007 or later, code the histology 8441/3 [Serous carcinoma, NOS]. Use the Other Sites rules. Start with rule H8 and stop at rule H11. "Pattern" is not one of the terms used to identify a specific type (See H16), so papillary is ignored.
Laterality--Heme & Lymphoid Neoplasms: Is laterality coded to 0 [not paired] for all lymphoma cases including paired sites (e.g., breast, lung)?
Laterality coding for lymphomas is based on the primary site not histology. Laterality describes the side of a paired organ or side of the body on which the reportable tumor originated. Determine whether laterality should be coded for each primary.
Laterality coding instructions are located in the SEER Program Coding and Staging Manual. See pages 68-70 in the 2013 manual,
EOD Fields--All Sites: Is EOD information limited to what is available exactly two months from the day of diagnosis?
For cases diagnosed 1998-2003:
EOD should include all information available within four months of diagnosis in the absence of disease progression or through completion of surgery(ies) in first course of treatment, whichever is longer.
Mets known to have developed after EOD was established should be excluded.
Multiple Primaries--Lymphoma: How many primaries are abstracted for a patient with a 1995 periaortic lymph node biopsy showing lymphocytic lymphoma, diffuse small cleaved probable intermediate grade B cell positive, followed by stomach biopsies on 6/18/05 showing diffuse large B cell lymphoma and on 6/24/05 showing malignant lymphoma, tumor cells positive for [CD20] B cell respectively?
For cases diagnosed prior to 1/1/2010:There are two primaries:
Lymphocytic lymphoma, diffuse, intermediate in 1995
Diffuse large B-cell lymphoma in June, 2005
According to the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table, 9673 [Malignant lymphoma, lymphocytic, diffuse, intermediate] and 9680 [Malignant lymphoma, large B-Cell, diffuse] are separate primaries. Again, according to the table, 9680 [Malignant lymphoma, large B-Cell, diffuse] and 9591 [Malignant lymphoma, non-Hodgkin, NOS] are the same primary.
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.
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.
Radiation Sequence with Surgery--Head & Neck: How is this field coded for a tonsil primary diagnosed on 4/16/07 by a regional lymph node FNA when the patient subsequently initiates radiation on 5/8/07 and has a tonsillectomy with neck dissection on 7/30/07?
The best way to handle this situation is to assign code 2 [Radiation before surgery] in Radiation Sequence with Surgery. Code 2 provides the best description of the sequence of events in this case. Radiation was delivered prior to the resection of the primary site.
An official website of the United States government
Home