System Guide
Back to Search Results

Search Results

Display Options
Display Options
Select Fields
Export Results to CSV Create Report 0
+ Add all results to report

Report Produced: 03/04/2026 02:30 AM

Report Question ID Question Discussion Answer Year
20091061 Multiplicity Counter--Head & Neck: How is this field coded when a patient has carcinoma in the same location as a previous primary but it is unknown if there was a disease-free interval? See Discussion. Patient was diagnosed with squamous cell carcinoma, single tumor of the right true vocal cord in May 2008. Tumor was treated with radiation therapy and chemotherapy. Excision of right vocal cord mass in February 2009 shows squamous cell carcinoma. Assign code 01 [one tumor only] for the example provided (see discussion). Given the information provided, there is no reason to suspect that the February 2009 diagnosis represents new tumor; therefore, it does not affect the multiplicity counter. It appears that this was the treatment plan for the original diagnosis in May 2008: radiation and chemo followed by excision of the mass. 2009
20091009 MP/H Rules/Histology--Kidney: How do you code histology for a renal cell carcinoma when pathologists disagree as to whether or not the tumor is consistent with thyroid-like follicular carcinoma of the kidney? See Discussion. Final diagnosis states 'left radical nephrectomy, renal cell carcinoma.' The CAP Histologic Type is listed as: Unclassified, most consistent with primary thyroid-like follicular carcinoma of the kidney.' Because of the unusual histology it was sent for a consult to a genitourinary pathology specialist. His response was: 'histologic features not typical for any of the known subtypes of renal cell carcinoma and are not consistent with primary thyroid-like follicular carcinoma of the kidney, a distinct renal tumor that we have recently published in the literature.' The tumor was TTF-1 negative, arguing against metastasis from a thyroid primary. For cases diagnosed 2007 or later, assign code 8312 [renal cell carcinoma, NOS]. The diagnosis is renal cell carcinoma, but the specific type is in question. 2009
20091012 MP/H Rules/Histology--Head & Neck: If the final diagnosis states "see microscopic description," can the micro information be used to code the histology? See Discussion. In regards to coding histology for 2007 and forward cases, we are instructed to use the final diagnosis, and any addenda or comments associated with the final diagnosis. We are not to use the microscopic description. However, we are seeing pathology reports with a final diagnosis that also includes the notation "see microscopic description" or "see description". Example: "Left Parotid: High grade carcinoma involving deep lobe with marginal extension. See description." The microscopic description goes on to describe the carcinoma in more detail, which includes a statement "consistent with the ductal type of primary parotid carcinoma." Can we use this microscopic description or not?

For cases diagnosed 2007 or later:

When the final diagnosis indicates that the microscopic section contains the detailed diagnosis, use the microscopic description to code the histology.

Otherwise, code from the final diagnosis only and not from the microscopic description. The final diagnosis is usually the pathologist's conclusion after consideration of the various choices listed in the microscopic description. The histology code should represent the pathologist's final conclusion.

 2009
20091112 Grade-Breast: How is this field coded for a breast tumor described as "intermediate nuclear grade"? See Discussion.

Guidelines for selecting grade for breast primaries prioritize nuclear grade right after B&R grade. The conversion table displays only numeric values for nuclear grade. How is grade coded for tumors in which nuclear grade is described by terminology? Does it make a difference if the tumor is invasive or in situ?

Example 1: Ductal carcinoma, intermediate nuclear grade.

Example 2: Ductal carcinoma, high nuclear grade.

Example 3: Ductal carcinoma, moderate nuclear grade.

Example 4: DCIS, intermediate nuclear grade.

Use the table on page C-607 of the 2007 SEER manual. The terms "low," "intermediate," and "high" appear in the column labeled "BR Grade." Use this column to determine the appropriate grade code when grade is described using these terms. If the grade of an in situ tumor is described using these terms, use the table to determine the appropriate code for the grade field. 2009
20091015 MP/H Rules/Histology--Gallbladder: What histology is coded for a tumor described as "90% high grade neuroendocrine ca, large cell type; and 10% low grade adenocarcinoma, conventional type"?

For cases diagnosed 2007 or later:

MP/H Rule H17 for Other Sites applies. Code the histology 8140 [adenocarcinoma].

The ICD-O-3 code for large cell neuroendocrine carcinoma is 8013 and the code for adenocarcinoma is 8140.

 2009
20091051 MP/H Rules/HistologyCorpus Uteri: How should histology be coded for a "carcinosarcoma with high grade sarcomatous component within a polyp, with greater component of endometrioid carcinoma and foci papillary serous carcinoma within polyp"? For cases diagnosed 2007 or later, assign code 8980/3 [Carcinosarcoma] according to rule H17. Rule H12 does not apply since the final diagnosis is not "adenocarcinoma." 2009
20091120

MP/H Rules/Histology--Esophagus: Should the modifying expression "with areas of" be used to code histology? See Discussion.

Patient was found to have two tumors in the esophagus. The large tumor was diagnosed as adenocarcinoma with areas of neuroendocrine differentiation (small cell carcinoma). The smaller tumor was diagnosed as small cell carcinoma. If we accept the "areas of" to be part of the diagnosis, rule H16 indicates that histology for the large tumor would be coded 8045 (combined small cell and adenocarcinoma). If we ignore the "areas of," then histology for the large tumor would be coded to 8140 (adenocarcinoma). Either way, when counting primaries, rule M17 would be applied and the two tumors would be classified as separate primaries. However, it seems that the two tumors are probably the same disease process since they both show small cell carcinoma.

For cases diagnosed 2007 or later, do not use the modifying expression "with areas of" to determine a more specific histology per rule H13 in the MP/H rules.

 2009
20091034 CS Extension--Ovary: How are the following terms coded when they are described in the medical record without any other qualifying information? Seeding, talcum powder appearance, salting, miliary, and studding.

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.Seeding, talcum powder appearance, salting and studding are synonymous with implants. When the size of implants is not stated, but operative report and scans state "seeding," "talcum powder appearance," "salting," and "studding" the CS extension code choice will depend on the location of the seeding, talcum powder appearance, salting, or studding.

The word "miliary" is not documented as a synonym for implants.

The term miliary does not affect the CS extension code choice according to the current CS instructions.

 2009
20091115 MP/H Rules/Multiple primaries - - Melanoma: How many primaries are reported when a patient presents with a malignant melanoma (NOS) and a separate lentigo maligna, both on right chest? See Discussion.

MP/H rule M5 states that melanomas with ICD-O-3 histology codes that are different at the third number are multiple primaries. However, the 2007 MP/H fundamentals Webcast session on melanoma rules states that this is not two histologic types. Lentigo maligna is a growth pattern, not a histologic type. Will clarification be included in the next MP/H rules revision?

For cases diagnosed 2007 or later, two primaries are to be reported for this case. Rule M5 applies because there is a difference in the histology codes at the third digit.

Clarifications regarding histologic types of melanoma will be added to the rules when they are revised.

2009
20091040 MP/H Rules/Histology--Breast: How is histology coded for an "infiltrating papillary carcinoma" of the breast when there is no mention of ductal or adenocarcinoma in the pathology report?

For cases diagnosed 2007 or later, assign histology code 8503 [Papillary adenocarcinoma]. Rule H14 applies.

ICD-O-3 code 8050 does not apply in this case. Refer to the numeric listing in ICD-O-3. 8050 is a squamous cell neoplasm. Papillary carcinoma of the breast is NOT a squamous cell neoplasm. It is a neoplasm of the breast parenchyma - ducts, lobules or connective tissue. 8503 is the correct code in this case.

 2009