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Report Produced: 02/21/2026 20:45 PM

Report Question ID Question Discussion Answer Year
20000469 Reason for No Cancer-Directed Surgery--Lung: How do you code this field for a lung primary that presents with metastasis to the bone and brain in which the oncologist's treatment plan includes only radiation and chemotherapy? Code the Reason for No Cancer-Directed Surgery field to 1 [Cancer-Directed Surgery Not Recommended]. 2000
20010050 Chemotherapy--Hematopoietic, NOS: What treatment code is used to represent the drug "Gleevec" being used to treat chronic myelogenous leukemia? For cases diagnosed 1/1/2003 and after: Code the Chemotherapy field to 02 [Single-agent chemotherapy administered as first course therapy]. It should be classified as a chemotherapy agent, albeit a unique one. Gleevec seems to work the same way many other chemo drugs do. It disrupts cell division for malignant cells containing the BCR-ABL protein only, rather than for normal and abnormal cells together. When the cells can't divide and create a new generation, they simply die. This meets the definition of an antineoplastic chemotherapy agent. 2001
20091023 Sugery of Primary Site--Breast: When a patient is simultaneously diagnosed with bilateral breast cancer and bilateral mastectomies are done, do you code the total mastectomies to 40 or 41 or 42?

Abstract cancer of the left breast and cancer of the right breast as separate primaries. Code the surgery for each primary independent of the other primary.

For the first primary, assign code 41 [Total (simple) mastectomy, NOS WITHOUT removal of uninvolved contralateral breast].

For the second primary, assign the code for the procedure performed on that site.

 2009
20160016

MP/H Rules/Histology--Bladder: Can the histology for a high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" be coded to sarcomatoid transitional cell carcinoma (8122/3)?

Example; TURBT, Final Diagnosis - Urothelial carcinoma, high grade. Type/grade comment: Extensive sarcomatoid dedifferentiation is present (40-50% of tumor volume).

Code high grade urothelial carcinoma described as having "extensive sarcomatoid dedifferentiation" to sarcomatoid transitional cell carcinoma (8122/3).

2016
20180092

Reportability/Histology--Brain and CNS: Is diffuse intrinsic pontine glioma is reportable? If yes, what is the correct histology code?

Diffuse intrinsic pontine glioma is reportable. For cases diagnosed in 2018, assign 9385/3.

 2018
20081133 MP/H Rules--Breast: What histology code is used for lobular carcinoma, pleomorphic type? For cases diagnosed 2007 or later, use rule H14 and code the histology 8520 [lobular carcinoma]. 8520 is the only ICD-O-3 code for lobular carcinoma. There are no codes for specific lobular types. 2008
20041048 Grade, Differentiation: How is this field coded when a pathologist notes the grade of a tumor is "mid-differentiated"? Code Grade, Differentiation to 2 [Moderately differentiated]. 2004
20210034

Reportability/Histology--Endometrium: Is endometrial hyperplasia with atypia equivalent to atypical hyperplasia of the endometrium (8380/2) and thus reportable?

Endometrial hyperplasia with atypia is equivalent to atypical hyperplasia of the endometrium (8380/2) and thus reportable for cases diagnosed 2021 and later. Our expert pathologist consultant confirmed this for us.

 2021
20130140 Reportability/Ambiguous terminology--Heme & Lymphoid Neoplasms: Is a peripheral blood sample with an immunophenotype that is "characteristic of B-cell chronic lymphocytic leukemia" reportable?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

This is a reportable diagnosis of chronic lymphocytic leukemia [9823/3]. The physician is using the terms "characteristic of" in the same manner as he/she would use the terms "diagnostic of."

This case fits with the usual diagnosis of CLL. The peripheral blood is diagnostic for leukemias. There was a specific leukemia noted, B-cell chronic lymphocytic leukemia. CLL (B-cell is the phenotype) is usually diagnosed incidentally by a peripheral smear because it is asymptomatic. However, we recommend looking for further work-up, such as a bone marrow biopsy.

SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx.

2013
20150045

MP/H/Histology--Thyroid:  What is the histology code for primary site of thyroid cancer with the histology of papillary thyroid carcinoma, classical and oncocytic type?

Code the histology to 8342/3, thyroid oncocytic (oxyphillic) papillary carcinoma.

2015