CS Extension--Hematopoietic, NOS: Can this field be coded to 10 [Localized disease] for an extramedullary plasmacytoma that is limited to an extramedullary primary, such as appendix, given that this histology is not listed as one of the allowable histology/CS extension combinations for this code? See Discussion.
The Hematopoietic Diseases scheme for CS lists specific histologies for which CS Extension can be coded to 10. Included is plasmacytoma, NOS [9731/3]. However, extramedullary plasmacytoma [9734/3] is not listed as one of the histologies.
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.Assign code 10 [Localized disease].
Both the 2007 SEER manual (page C-1072) and the CS Version 01.04.00 manual (page II-550) have been updated to include 9734 [extramedullary plasmacytoma] under extension code 10.
CS Extension--Head of Pancreas: What code is used to represent extension to the superior mesenteric artery? See Discussion.
In the CS coding scheme for Head of Pancreas, superior mesenteric artery is listed under both code 54 (T3) and 60 (T4).
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.
Assign code 60 for a primary in the head of the pancreas extending to the superior mesenteric artery. CS Extension code 54 should be Superior mesenteric VEIN and code 60 should be Superior mesenteric ARTERY. An errata will be issued by CS. In addition, extension 54 indicates resectable disease and code 60 is not resectable.
CS Extension--Head & Neck: If a 2 cm left tonsil primary extends to the lateral aspect of the soft palate, should extension be coded to 40 [Soft palate, inferior surface including uvula or soft palate NOS] or 42 [Soft palate, superior (nasopharyngeal) surface] for a tonsil primary?
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.
Extension code 40 is for extension from the tonsil to the back (lower) part of the soft palate, or soft palate, NOS. Code 42 is for extension to the front (higher, nasopharyngeal surface) part of the soft palate.
Inferior soft palate is the back (lower) part of the soft palate (C051). Superior soft palate is the front, (nasopharyngeal surface) of the soft palate (C113).
CS Extension--Head & Neck (Larynx): If a patient with cancer of the larynx is described as experiencing hoarseness, is that sufficient information to code "vocal cord fixation" or does that phrase need to be used?
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.
Do not code vocal cord fixation when the only information available is "hoarseness." Vocal cord fixation must be documented on endoscopy. Hoarseness is a common presenting symptom of laryngeal malignancy.
CS Extension--Extramedullary Plasmacytoma: Under what circumstance would CS extension code 80 be used in a case of extramedullary plasmacytoma?
For cases diagnosed prior to 1/1/2010, 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.
Assign CS extension code 80 [Systemic disease] for extramedullary plasmacytoma involving more than one site. Use code 80 when extramedullary plasmacytoma is NOT single, solitary, unifocal, isolated, mono-ostotic or localized. Code 80 can also be used when the bone marrow is involved but the plasma cells are <10%.
Do not apply EOD instructions to CS.
For cases diagnosed 1/1/10 and later, 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.
CS Extension--Corpus uteri: Can a suspicious cytology be used to code extension? See Discussion.
Endometrial primary confirmed by biopsy on 10/26/06. Pelvic washing on 11/14/06 was 'suspicious for malignancy.' Resection path the same day stated the primary tumor invades the inner 1/3 of the myometrium.
Can we use the pelvic washing cytology & code CS extension 61 or should CS extension be coded 12?
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.Assign extension code 61 [cancer cells in peritoneal washings] for the case described above.
"Suspicious" is listed as a term indicating involvement. There is no exception noted for cytology reports. See page 122 of the 2007 SEER manual.
CS Extension--Colon: What is the difference between codes 46 [Adherent to other organs or structures, but no microscopic tumor found in adhesion(s)] and 57 [Adherent to other organs or structures, NOS]? See Discussion.
Code 46 reads "Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)".
Would these examples be coded to 46?
Example 1: 7/04 Op findings: mass was adherent to duodenum without obvious invasion. Path: margins negative (no mention of duodenum). Case staged to pT3.
Example 2: Op findings: large mass involving cecum adherent to peritoneum & retroperitoneum. Path: invasion of pericolic soft tissue; margins negative (no metion of peritoneum & retroperitoneum). Case staged to pT3.
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.
Code 46: Attached to other organ (on imaging or surgical observation); pathology says no invasion of the other organ. Code 57: Attached to other organ; pathology is positive for invasion of other organ, or pathology does not specify whether there is invasion of the other organ.
Example 1: Code extension to 46 [Adherent to other organs or sturcture, but no microscopic tumor found in adhesion(s)]. The tumor was attached to the duodenum, but not invading
Example 2: Code extension to 46 [Adherent to other organs or structure, but no microscopic tumor found in adhesion(s)]. The tumor was attached to peritoneum & retroperitoneum, but not invading based on negative margins and no peritoneum or retroperitoneum specimen submitted to pathologist.
CS Extension--Cervix: How are "positive pelvic washings" coded for a cervical primary?
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.
According to the CS Steering Committee, positive pelvic washings for primary cervical cancer are not part of the staging criteria in the collaborative staging system (nor in TNM and FIGO). Document positive pelvic washings in a text field. The CS steering committee will add a statement to CS extension to clarify this for cervix uteri.
CS Extension--Breast: What is the CS Extent for this 2004 breast cancer? See Discussion.
A patient had lobular carcinoma of the left breast in 2000. At that time, she had bilateral simple mastectomies and the right breast was benign. In 2004, she notices a nodule in the right chest wall, which is excised and found to be invasive ductal ca and lobular ca in situ. So is this Sequence 2, C50.9, 8522/3. And what is the CS Extent - 40 chest wall? (The physician stages this as T2N0M0)
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.Residual breast tissue is present following a mastectomy. If the nodule is in the breast tissue (tissue above the ribs), assign CS extension code 10 [Confined to breast tissue...Localized, NOS]. If the nodule is in the chest wall (tissue below the ribs), assign code 40 [Invasion of chest wall].
CS Extension--Breast: Is the term "erosion" the same as "ulceration"?
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.
"Erosion" is not synonymous with "ulceration" when coding CS extension for breast.
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