Report | Question ID | Question | Discussion | Answer | Year |
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20061047 | CS Extension/CS Mets at Dx--Peritoneum: How are these fields coded for extraovarian peritoneal carcinomas presenting with multiple peritoneal implants? See Discussion. | Patient presented with large omental cake and multiple peritoneal implants including implants on the rectosigmoid serosa and right ovary. Path revealed papillary serous adenocarcinoma consistent with peritoneal primary. Per AJCC Manual, extraovarian peritoneal carcinoma is usually staged with the ovarian staging classification. We understand that the CS Manual will eventually be revised to include staging for extraovarian peritoneal primaries. In the meantime, how do we use the existing CS scheme for peritoneum to code these cases? |
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 CS Extension 99 [unknown] and CS Mets at DX 99 [unknown]. The issue has been sent to the CS steering committee for resolution. This answer will be updated when the steering committee provides a resolution. |
2006 |
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20061002 | Multiple Primaries (Pre-2007): How many primaries? See Discussion. | 5/05 perianal skin bx, 6/05 mapping bx perianal skin, 9/05 punch bx perianal skin: all positive for extramammary Paget Disease. 9/05 Perianal Excision of Paget w/V-Y flap repair. Path: Perianal and anal skin: Extramammary Paget disease associated with: Invasive adenoca of anal canal. Anal margins positive for invasive adenoca. Comment: invasive adenoca with local mucinous features involving the anal margin/end of specimen. This adenoca is in continuity with (associated with) extensively diffuse extramammary Paget disease. Unclear whether the adenoca represents a rectal primary with spread to perianal area, anal gland adenoca or mets. 12/05 AP resection-no residual Paget or invasive neoplasm. | For tumors diagnosed prior to 2007:
There is one primary. Code the histology to 8542 [Paget disease, extramammary]. Code the primary site C210 [anus]. Histology rule 7 on page 87 of the 2004 SPCM applies in this case.
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. |
2006 |
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20061036 | CS Extension--Lymphoma: For lymphoma cases, can extension be coded to 80 [Nodular involvement of lungs] based on imaging or operative findings when there is no positive statement of involvement? See Discussion. | Specifically, CS Ext code 80 includes nodular involvement of the lungs. The CT report for this patient states that the lungs are nodular. Is that enough to use code 80? Can the liver be coded as involved based on the operative findings? Scenario: The patient was diagnosed with lymphoma. The CT showed pulmonary nodules. The pt had an exploratory laparotomy with a positive mesenteric LN bx and a positive ileocecectomy. The operative findings included a nodular liver. No staging was done by the oncologist and he has the pt on CHOP-R. |
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 80 can be assigned based on imaging or operative findings as in the lymphoma case described above. The fact that this extension was not based on pathological evidence is captured in the evaluation code. Assign CS/TS Ext-Eval code 0 [No staging laparotomy done. No autopsy evidence used (clinical)]. |
2006 |
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20061029 | Recurrence (Pre-2007)--Colon: When there is no statement of recurrence on the abstract, is a colon tumor at the anastomosis site a recurrence of the previous colon cancer or a new primary? |
For tumors diagnosed prior to 2007: If the cancer at the anastamosis site is more than two months after the previous colon cancer, abstract as a separate primary. If the cancer at the anastamosis site is within two months of the original diagnosis and the histologies are the same, do not abstract as a separate primary. 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. |
2006 | |
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20061054 | First Course Treatment/Chemotherapy: Is adriamycin used in a chemoembolization procedure coded as chemotherapy? | Code as chemotherapy only when a chemotherapeutic agent is used, such as adriamycin. Do not automatically code chemoembolization as chemotherapy. | 2006 | |
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20061146 | Primary Site--Hematopoietic, NOS: Are there any guidelines for the use of topography code C420 [blood] rather than C421 [bone marrow], or C424 [Hematopoietic system, NOS] for hematopoietic diseases other than Waldenstrom macroglobulinemia? | For cases diagnosed prior to 1/1/2010:There are no specific guidelines concerning code C420 versus C421 or C424, other than the suggested topography codes in ICD-O-3 (see Rule H). The Hematopoietic task force is in the early phases of developing guidelines for these diseases. This issue will be presented to the task force for their consideration. For cases diagnosed 2010 forward, 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. |
2006 | |
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20061018 | Multiple Primaries (Pre-2007)--Brain and CNS: Is neurofibromatosis a separate and distinct primary in the presence of a longstanding glioma? Does the following show one or two primaries? See Discussion. | MRI of Brain: 1. Findings compatible with left optic nerve glioma. 2. Stable enhancing focus in left temporal white matter. Lack of interval change since Dec 2000 suggests a white matter finding typical of neurofibromatosis and makes more aggressive processes such as astrocytoma less likely. Small aneurysm can not be excluded. | For tumors diagnosed prior to 2007:
Neurofibromatosis and glioma would be separate brain/CNS primaries. However, there is only one primary in the case example above: Glioma, left opic nerve. "...suggests a white matter finding typical of neurofibromatosis" is not reportable. "Suggests" is not a reportable term. Therefore, in this example neurofibromatosis is not reportable unless there is a more definitive statement in the record.
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. |
2006 |
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20061053 | Diagnostic Confirmation: How is this field coded for a case with a cytology that is suspicious for ductal carcinoma and the clinical diagnosis is carcinoma? See Discussion. | SINQ 20031152 states that histology for this type of case is to be coded per the clinical diagnosis of "carcinoma." Does it follow then that Diagnostic Confirmation is to be coded 8 (clinical diagnosis only)? Would we code Diagnostic Confirmation differently if the clinician stated that the diagnosis of malignancy was confirmed by the suspicious cytology? | Code diagnostic confirmation as 8 [clincial diagnosis] when there is a suspicious cytology and a physician's clinical diagnosis. Do not accession cases with only suspicious cytology. Code diagnostic confirmation as 8 when the clinician's diagnosis of malignancy is confirmed by the suspicious cytology. It is still a clinical diagnosis made by the physician using the information available for the case. |
2006 |
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20061113 | Histology (Pre-2007)--Melanoma: How is histology coded for a final pathology diagnosis of "malignant melanoma, NOS" that is clinically described as a nevus? | For tumors diagnosed prior to 2007:
Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].
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. |
2006 | |
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20061098 | CS Extension/CS Mets: For primary sites within the peritoneum (abdominalpelvic walls) such as stomach, colon, does the presence of malignant ascites affect the coding of CS Extension or CS Mets? | 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. The Collaborative Staging system is governed by site-specific coding rules. Refer to each set of site rules rather than looking for a general answer for all sites in peritoneum. In particular, Ovary and Corpus allow malignant ascites to be coded in CS Extension, but not CS Mets at Dx. For each site, both CS Extension and CS Mets at Dx should be checked for the proper field to code malignant ascites. |
2006 |