Report | Question ID | Question | Discussion | Answer | Year |
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20000532 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: Should a lymph node biopsy be counted in these fields or are these fields for lymph node dissections only? See discussion. | Example: 1) Lymph node biopsy: adenocarcinoma. 2) Lymph node dissection: 4/15 regional lymph nodes positive for adenocarcinoma. | For cases diagnosed 1998-2003:
These fields record the number of regional lymph nodes examined pathologically whether from a biopsy or from a dissection. If the single lymph node biopsied was a regional lymph node, code the Number of Regional Lymph Nodes Positive field to 05 and the Number of Regional Lymph Nodes Examined field to 16. If the lymph node biopsied was a distant node, code these fields to 04 and 15 respectively. |
2000 |
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20031205 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded when an autopsy report reveals pathologically involved regional lymph nodes but does not state how many nodes were positive nor how many were examined? See Description. | A final autopsy report described widely disseminated adenocarcinoma, probably lung primary. Metastatic tumor in brain, lungs, and in lymph nodes. The Gross description of the autopsy report stated that there were numerous metastases to hilar and mediastinal lymph nodes. The Micro description of the autopsy report did not add any clarification. In the absence of a stated number of lymph nodes, the options for coding number of regional lymph nodes examined are codes 96-98. These codes include descriptions of surgical procedures such as sampling and dissection. How do we code number of regional lymph nodes examined when the pathological examination of lymph nodes was done only at autopsy and not during a surgical procedure? | For cases diagnosed 1998-2003: The rules that apply to the use of pathology reports for EOD coding also apply to autopsy reports. When a cancer diagnosis is made and positive lymph nodes are discovered on autopsy, in the absence of a stated number of lymph nodes, code the number of lymph nodes positive to 97 [Positive nodes but number of positive nodes not specified]. Code the number of lymph nodes examined to 97 [Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated]. An autopsy is a dissection. |
2003 |
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20000549 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: How are these fields coded if radiation to the primary site and/or regional lymph nodes is performed prior to surgery? | For cases diagnosed 1998-2003:
Code the EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined fields per the information in the pathology report(s). Radiation to the primary site would not affect the status of the lymph node involvement. Radiation to the regional lymph node region may or may not affect the pathologic status of the lymph nodes. However, for these fields code the best information available about the status of the lymph nodes which is reflected in the pathology report(s). |
2000 | |
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20000486 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined/Surgical Procedure of Other Site--Kaposi Sarcoma: How do you code these fields for a groin mass excision containing 4 lymph nodes for a Kaposi sarcoma case that presented with multiple skin lesions? | Code the EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined fields to 99 99 for Kaposi cases that present systemically and for those that present in more than one site (which includes cases with more than one skin subsite involved at diagnosis). There are no "regional" lymph nodes for such cases. This represents a majority of currently diagnosed Kaposi cases. However, for localized Kaposi cases, you can count the number of regional lymph nodes positive and examined if the primary site selected has a regional lymph node chain(s) associated with it (e.g., soft palate, hard palate, or a skin subsite).
For cases diagnosed 1/1/2003 and after: Code the groin mass excision in the Surgical Procedure of Other Site field to 1 [Non-primary surgical procedure performed; Non-primary surgical resection to other site(s), unknown if whether the site(s) is regional or distant]. |
2000 | |
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20000844 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Colon: What codes are used to represent these fields when the pathology from a colon cancer resection describes 2/16 positive pericolonic lymph nodes and a "metastatic nodule in the pericolonic fat"? | For cases diagnosed 1998-2003:
Code the Number of Regional Lymph Nodes Positive field to 03 and the Number of Regional Lymph Nodes Examined field to 17. Each grossly detectable nodule in the pericolonic fat is counted as one regional lymph node. |
2000 | |
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20021063 | EOD-Pathologic Review of Number of Regional Lymph Nodes Examined: What code is used to represent this field when a path report from a lymph node biopsy or dissection describes lymph node "portions" or "fragments"? See discussion. | 1) Lymph nodes, right pelvic dissection: No evidence of malignancy in 4 portions of lymph node examined. (Should we code the number examined as 01, 04, or 97?) 2) Lymph nodes, left pelvic dissection: 5 fragments of lymph nodes show no evidence of malignancy. (Should we code the number examined as 05 or 97?) 3) Biopsy of right neck mass: Malignancy in fragments of lymph nodes. The following month, pt had a right modified lymph node dissection: 16/32 lymph nodes are positive for malignancy. (Should we code the number examined as 32, 33, 97, 98?) |
For cases diagnosed 1998-2003:
The total number of lymph nodes examined is recorded in EOD-Num of Reg LN Examined. If the number of actual lymph nodes represented by the "fragments" or "portions" cannot be determined, assign code 96, 97, or 98 as appropriate. 1) Based on the terminology "four portions of lymph node (singular)" code to 01 despite "dissection" terminology. 2) Code to 97 based on "fragments of lymph nodes (pleural)" terminology and procedure identified as dissection. 3) Code to 97 based on statement of "fragments of lymph nodes (pleural)" for biopsy plus dissection. |
2002 |
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20031059 | EOD-Pathologic Review of Number of Lymph Nodes Positive and Examined: How are nodes positive/examined coded for a positive FNA of a lymph node followed by a subsequent lymph node dissection? See Description. | A breast cancer patient had a FNA of an axillary lymph node positive for metastases. A modified radical mastectomy with lymph node dissection showed six lymph nodes negative for metastases.
Example 1: Patient received neoadjuvant chemotherapy prior to mastectomy and lymph node dissection. Example 2: Patient received no neoadjuvant therapy. |
For cases diagnosed 1998-2003, the number of Regional Nodes Positive and Examined include all nodes examined by the pathologist, unless there is disease progression. In other words, these fields are cumulative. An FNA alone, positive for regional lymph node metastasis is coded as 97 for number positive and 95 for number examined. 1 & 2. Assuming there has been no disease progression, include all nodes positive and all nodes examined from both the FNA and the lymph node dissection in the counts. Case example: Code number of regional nodes positive as 01, number examined as 07. | 2003 |
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20071005 | EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank? | For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis. |
2007 | |
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20000535 | EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the following phrases: "case staged as C" and "case staged as T3a"? See discussion. | Example: A prostatectomy was done on 6/29. The physician staged the case as a "C" on 7/2 and as T3a on 8/6. It appears the physician is interpreting the following pathology information as unilateral extracapsular extension: "The tumor on the right extends to the inked surface of the gland. In this area the capsule appears absent." Should pathologic extension be coded to unilateral extracapsular extension [42]?
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For cases diagnosed 1998-2003:
Yes. Use the best information available to stage this case. In this case, the best information is the physician's statement that the case is stage T3a. Without any additional information, the EOD-Extension field is coded to 42 [Unilateral extracapsular extension (pT3a)] on the basis of the T3a stage by the MD. When there is a conflict between different staging systems, default to the AJCC stage. |
2000 |
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20000247 | EOD-Pathologic Extension--Prostate: If there is residual tumor in the distal urethra on prostatectomy, does that mean there is distal urethral margin involvement? See discussion. | 2/98 Prostate bx: Right apex, right mid and right base positive for adenocarcinoma. 6/1/98 Radical retropubic prostatectomy w/ bilateral pelvic lymph node dissection. Pathology: Residual adenocarcinoma in distal urethra, right lateral sections and posterior lobe. Right apical margin, other margins, seminal vesicles, and 7 pelvic LN negative for malignancy. |
For cases diagnosed 1998-2003: For the example above, code the EOD-Pathologic Extension field to 34 [extending to apex] because most of the right side is involved. The pathology report says all margins are free. The comment on residual tumor in the urethra, meant the first surgery did not completely remove tumor tissue from the urethra, it does not mean that tissue is at the margin. |
2000 |