CS Tumor Size/CS Extension--Brain and CNS: How are these fields coded for a glioblastoma multiforme occurring in a 3.5 cm tumor in the parietal lobe and a 3.0 cm tumor in the occipital lobe?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.
CS Extension code is 10 [confined to cerebral hemisphere]. Record the size of the largest lesion in CS Tumor Size. Both the occipital and parietal lobes are supratentorial and confined to the cerebral hemisphere with no mention of crossing midline or involvement of ventricles.
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.
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,
Reportability--Skin: Effective 2021, a cutaneous leiomyosarcoma is a related term for smooth muscle tumor, NOS (8897/1) in ICD-O-3.2. Currently, we have been capturing these as a C44_ (leiomyosarcoma, 8890/3) but the 2019 SEER inquiry states that atypical intradermal smooth muscle neoplasm (AISMN) was previously termed cutaneous leiomyosarcoma. This is not documented on the 2018 ICD-O-3 updates. Should this 2019 case be 8897/1 or 8890/3?
Cutaneous leiomyosarcoma is reportable for 2019. Code histology to leiomyosarcoma 8890/3.
As of cases diagnosed 1/1/2021, it is no longer reportable based on assignment to 8897/1 in ICD-O-3.2.
Surgery of Primary Site--Corpus uteri: What is the correct surgery code to assign for dilation and curettage (D&C) for an in-situ endometrium (C541) primary? The code to use for the cervix uteri (C530-C539) is specified, but not for the corpus uteri (C540-C549).
Assign code 20 for endometrial D&C for in situ cancer of endometrium.
Primary Site--Breast: What subsite is to be coded for a case of invasive Paget disease of the nipple with an infiltrating ductal carcinoma of the lower inner quadrant?
Code C50.9 [Breast, NOS]. Code the last digit of the primary site to '9' for single primaries when multiple tumors arise in different subsites of the same anatomic site and the point of origin cannot be determined. Nipple [C50.0] and LIQ [C50.3] fit this rule. This is a single primary per MP/H Breast Rule M9.
Solid Tumor Rules (2018)/Histology--Lung: What is the histology code of a 2018 lung cancer case with invasive non-mucinous adenocarcinoma? For non-mucinous carcinoma/adenocarcinoma, the Solid Tumor Rules have codes for microinvasive, minimally invasive, preinvasive, and in situ. Do we default to the microinvasive/minimally invasive code?
Code histology to adenocarcinoma, NOS (8140/3). The World Health Organization and the College of American Pathologists no longer recognize non-mucinous carcinoma/adenocarcinoma, NOS. Pathologists are discouraged from using this term. Microinvasive/minimally invasive lung tumors have very specific criteria and these criteria do not apply to non-mucinous carcinoma, NOS.
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