First course of treatment: What is the correct code to use for allogenic stem cell transplant?
Code an allogenic stem cell transplant as 20 (Stem cell harvest (stem cell transplant) and infusion) in Hematologic Transplant and Endocrine Procedures in the 2016 SEER Manual.
Histology (Pre-2007)--Lung: Does 8070 [squamous cell carcinoma], 8560 [adenosquamous carcinoma] or 8255 [adenocarcinoma with mixed subtypes] best represent this field for a lung biopsy described as a "poorly differentiated non-small cell carcinoma with squamous and glandular features with focal mucin positivity per mucin stain"?
For tumors diagnosed prior to 2007:
Assign code 8560/33 [Adenosquamous carcinoma, poorly differentiated]. "Glandular" carcinoma is a synonym for adenocarcinoma. Mixed adenocarcinoma and squamous carcinoma is coded to 8560. Do not use code 8255 [Adenocarcinoma with mixed subtypes] when a more specific complex code is available.
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.
Reportability--Breast: Is an inflammatory myofibroblastic tumor of the breast with metastasis to the lung reportable?
Inflammatory myofibroblastic tumor of the breast with metastasis to the lung is reportable. Metastasis to the lung from the breast tumor indicates that the breast tumor is malignant. All malignant neoplasms are reportable.
Grade, Differentiation--Breast: Does SEER agree with our pathologist who contends that "by convention lobular carcinoma is considered to be grade 2"?
No. SEER does not have a default grade code for lobular carcinoma. Code the grade as stated in the pathology report. If no grade is stated, code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable].
Histology (Pre-2007): Is 8524 [lobular mixed with other carcinoma] or 8490 [signet ring cell carcinoma] used to represent a diagnosis of "infiltrating lobular with signet ring features?"
For tumors diagnosed prior to January 1, 2004:
According to our pathologist consultant, for this specific case, code to 8490 [Signet ring cell carcinoma].
Our pathologist states: "Signet ring cell carcinoma is most often a variant of lobular carcinoma (as it appears to be in this case - it is less frequently a variant of ductal), and I think it's appropriate to code it as such. Coding to lobular would also be ok, though that would lose the special feature of the signet ring cells. I would rather not code to 8524, since it is not really a mix of lobular and something else."
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.
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.
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.
Primary Site--Brain and CNS: Are meninges surrounding cranial nerves cranial meninges [C700] or a part of the specific nerve's sheath? Is the primary site for an optic nerve sheath meningioma coded to optic nerve [C723] or cranial meninges [C700]?
MP/H Rules/Histology--Thyroid: How is histology coded for a thyroid tumor described as "predominantly papillary carcinoma, tall cell variant, follicular type"?
For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites.
"Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored.