First course treatment--Heme & Lymphoid Neoplasms: Why isn't darbepoietin coded as treatment for hematopoietic diseases?
Darbepoietin is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anemia, commonly associated with chronic renal failure and cancer chemotherapy.
Darbepoietin is a support medication; it does not treat cancer. It is used to treat anemia caused by cancer directed chemotherapy treatments. It is not indicated for patients with myeloid cancers; cancers that originate in the bone marrow like leukemia.
Darbopoietin is an ancillary drug and is not coded as treatment.
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
Date of Diagnosis/Ambiguous Terminology--Lung: Would the date of a PET scan that states there is a mass in the lung which is "in the range of malignancy " be coded as the date of diagnosis or would the date of a subsequent bronchoscopy with biopsy be used for diagnosis date because it confirms a malignancy?
The date of diagnosis in this case is the date of the bronchoscopy with biopsy.
"In the range of malignancy" is not one of the ambiguous terms that are reportable. Please see the list of reportable ambiguous terms on page 3 of the 2004 SEER manual. Do not accession cases based on ambiguous terms not found on the reportable list.
Histology/Date of Diagnosis--Hematopoietic, NOS: What code is used to represent histology for a June 2001 diagnosis of "myelodysplastic syndrome" followed by a September 2001 bone marrow biopsy diagnosis of "myelodysplasia evolving into an acute leukemic state"?
For cases diagnosed prior to 1/1/2010:
Code the Histology field to 9989/3 [myelodysplastic syndrome] and the Date of Diagnosis field to June 2001.
For cases diagnosed 2010 forward, 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.
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].
Reportability/Ambiguous Terminology--Esophagus: Is a case with a biopsy diagnosis of "... focal areas suspicious for adenocarcinoma in situ change" reportable if the diagnosis on the partial esophagectomy specimen only includes the phrase "... with foci of high grade dysplasia; no invasive carcinoma identified"?
The case is not reportable.
The biopsy with a suspicious result (suspicious for adenocarcinoma) was disproven by the esophagectomy.
Scope of Regional Lymph Node Surgery/EOD-Number of Regional Nodes Examined: What codes is used to represent these fields when the surgeon states that a "lymph node dissection" was done, but no nodes are identified in the pathology report?
For cases diagnosed 1/1/2003 and after: Code the Scope of Regional Lymph Node Surgery field to 3 [Number of regional lymph nodes removed unknown or not stated; regional lymph nodes removed, NOS] and code the EOD-Number of Regional Nodes Examined field to 00 [No nodes examined].
The surgery fields reflect the procedures the physician performed. The EOD fields reflect the results of those procedures.
Reportability--Brain and CNS: Is Tuberculum sellae meningioma reportable? Is it same as sphenoidale meningioma?
Path: Brain tuberculum tumor resection: Meningioma, WHO grade I.
Revised answer based on ST rules
Yes, a Tuberculum sella meningioma is reportable if diagnosed 2004 or later. Code the primary site C700, cerebral meninges. It is a meningioma originating from the meninges of the Tuberculum sellae, which is part of the sphenoid bone.
Histology: What is the histology code for a soft tissue thigh mass that was diagnosed as Ewing sarcoma/PNET, primitive neuroectodermal tumor?
The histologies stated for this case are Ewing sarcoma (9260) and PNET, primitive neuroectodermal tumor,(9364)*. Use the Other Site Rules, starting with H8. Stop at H17 and assign the higher histology code -- 9364/3 [Peripheral neuroectodermal tumor].
*The term "PNET" is used for two different tumors. One is primitive neuroectodermal tumor (9473) and pertains to brain tumors per ICD-O-3 review. The other is peripheral primitive neuroectodermal tumor (pNET or PPNET 9364) and pertains to bone or soft tissue tumors. This case is stated to be soft tissue and Ewing sarcoma, so it is 9364 rather than 9473.
Histology: Is there any guidance on using STRATA Oncology testing (molecular tumor profiling tests), such as StrataNGS and StrataEXP, to code SSDIs, histology, etc? I do not see anything in STR, SEER Program Manual, SINQ, or CAnswerForum. We are seeing the testing with our 2021 paths.
We recommend that you do not use information from these molecular tumor profiling tests until they become a standard diagnostic tool. If/when that happens, we will add information to the various manuals.
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