Histology (Pre-2007): What code should be assigned to acinar adenocarcinoma and ductal adenocarcinoma?
For tumors diagnosed prior to 2007:
Assign code 8255 [Adenocarcinoma with mixed subtypes]. According to histology rule #4 for a single tumor on page 86 of the 2004 SEER manual, use a combination code if one exists.
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.
Histology (Pre-2007)--Breast: Is histology coded from the more representative specimen or should the combination code 8522/3 [Infiltrating duct and lobular carcinoma] be used for a case in which a right breast mass needle core biopsy revealed infiltrating ductal ca, grade III and the subsequent right mastectomy revealed a 2.3 cm lobular carcinoma?
For tumors diagnosed prior to 2007:
Code the histology using the final diagnosis on the pathology report of the procedure that resected the majority of the primary tumor. In this case, the mastectomy removed more of the tumor than the needle biopsy. The final diagnosis from the mastectomy is infiltrating lobular carcinoma. Code histology to 8520/3 [lobular carcinoma].
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.
Histology (Pre-2007)--Breast: What code is used to represent the histology of "invasive ductal carcinoma and in situ ductal carcinoma, cribriform type"?
For tumors diagnosed prior to 2007:
Code the Histology field to 8500/3 [ductal carcinoma] unless the combination is ductal and lobular.
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.
Grade, Differentiation--All Sites: What code is used to represent this field when there are invasive and in situ components in a tumor, but only the in situ component is graded (e.g., Invasive ductal carcinoma with high grade ductal carcinoma in situ)?
Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable]. The grade is taken from the invasive component only.
Date of Diagnosis--Sarcoma: Should the date of diagnosis be coded to the date of biopsy or the date of birth for an infant biopsied at 3 days of age and stated to have a diagnosis of congenital alveolar rhabdomyosarcoma, widely metastatic?
Code the date of the biopsy as the date of diagnosis. This is the date the cancer was first identified by a medical practitioner.
Note: SEER collects the Month and Year of diagnosis. The "day" of diagnosis is not collected by SEER.
First Course Therapy/Surgery of Primary Site--Prostate: What is the correct surgical code for irreversible electroporation ablation of the prostate diagnosed in 2021?
Assign code 17 for irreversible electroporation ablation of the prostate when there is no tissue submitted to pathology for a 2021 or 2022 case.
Primary site--Anus/Anal Canal: What site do you code squamous cell carcinoma of the anal verge?
Assign C211 for anal verge. Anal verge is defined as the lower (distal) end of the anal canal, junction between the skin of the anal canal and the perianal skin, http://www.seer.cancer.gov/manuals/2015/AppendixC/rectosigmoid/coding_guidelines.pdf
Reportability/MP/H Rules/Histology: Is malignant perivascular epithelioid cell tumor (PEComa) reportable, and if so, what is the histology code?
Malignant perivascular epithelioid cell tumor (PEComa) is reportable because it is malignant. Assign 8005/3 to malignant PEComa.
We consulted an ICD-O-3 expert who explained that some PEComas such as angiomyolipoma and lymphangiomyomatosis have specific ICD-O codes and their malignant counterparts may be coded to 8860/3 and 9174/3 respectively. There are no separate ICD-O codes for other specific PEComas, e.g., clear cell “sugar” tumor of lung, clear cell myomelanocytic tumor of the falciform ligament and some “unusual” clear cell tumors occurring in other organs—or for PEComa, NOS. These PEComas may therefore be coded to 8005 as clear cell tumors NOS; in other words as clear cell tumors that are not clear cell variants of carcinomas, sarcomas, or other specific tumor type.
Please note, PEComa is non-specific as to behavior. Unless the pathologist states that it is malignant, (as was the case for this question), the default code is 8005/1 (non-reportable).
First Course Treatment: What code is used to represent each treatment modality field when there is no indication that a particular modality of treatment was recommended or started?
Code the individual treatment fields to 0 or 00 [None] when the modality is not addressed in the treatment plan (or when a treatment plan is lacking) and there is no indication that a particular modality of treatment was recommended or started.
MP/H Rules/Multiple primaries--Breast: Does rule M10 apply in this situation?
L breast biopsy = INVASIVE DUCTAL CARCINOMA
L breast simple mastectomy = 2.0 cm INVASIVE DUCTAL CARCINOMA with an incidental finding of separate 1.0 cm INVASIVE LOBULAR CARCINOMA; pathologist specifically states the tumors are morphologically different. The tumors are both pure Ductal/pure Lobular.
Yes, Breast rule M10 applies. This case is a single primary.
Follow the MP/H rules even though the "pathologist specifically states the tumors are morphologically different" so that situations like this are reported consistenty accross cancer registries, regions, and states for consistent national reporting.
An official website of the United States government
Home