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Report Produced: 02/27/2026 18:19 PM

Report Question ID Question Discussion Answer Year
20031147 Reason No Cancer-Directed Surgery--Hematopoietic, NOS: Is this field always coded to 1 [not performed, not part of first course] for leukemias & other hematopoietic diseases? For cases diagnosed 2003 and later: For sites where "Surgery of the primary site" is coded 00 or 98 (hematopoietic included), Reason for No Surgery of Primary Site should be coded as 1 [Surgery of the primary site not performed because it was not part of the planned first course of treatment]. On rare occasions, there may be surgery to the primary site for a hematopoietic disease, such as an excisional biopsy of a myeloid sarcoma. Refer to the "Abstracting and Coding Guide for the Hematopoietic Diseases" for cell-type-specific treatment information. 2003
20031034

Histology (Pre-2007)--Kidney, renal pelvis: What codes are used to represent the histologies of 1) "renal papillary (chromophil) carcinoma" and 2) "chromophil renal cell carcinoma?"

For tumors diagnosed prior to 2007:

Code "chromophil" to 8260 [papillary renal cell]. According to our pathologist consultant, in the case of chromophil, most authors regard this as more or less synonymous with papillary renal cell [8260]. "More or less" because papillary is an old term descriptive of the microscopic structure, while chromophil is newer and based on the cytology; because most of the latter are papillary the current usage assumes them to be equivalent.

1) The diagnosis "renal papillary (chromophil) carcinoma" tells us that the pathologist who wrote it was seeing both pattern and cytologic features, and is regarding papillary equivalent to chromophil; thus, code to 8260.

2) Code "chromophil renal cell carcinoma" to 8260.

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.

 2003
20031141 Priorities/EOD-Lymph Nodes--Breast: Which part of the pathology report takes precedence when there is a discrepancy between the final path diagnosis and the CAP summary? See Description. For example, breast primary: Final path states "14/18 nodes (+) for tumor & separate matted aggregate of axillary nodes (+) for tumor. Subpectoral lymph node (+) for mets ca. Path Gross states "18 separate lymph nodes identified...many (+) for tumor grossly. Aggregate of matted lymph nodes within axillary tissue (+) for tumor. Multiple separate lymph nodes submitted." CAP Micro Summary lists "20/16 nodes examined/positive." What is correct number of nodes positive & nodes examined in this case? For cases diagnosed 1998-2003: The final pathology diagnosis has highest priority. The CAP summary is second priority. However, you always use the best information available. If the final path diagnosis is vague or unclear, information from the CAP summary can be used. In the case example, the total lymph node count from the final path diagnosis is unclear and the CAP summary provides clarification. Code the number of lymph nodes positive as 16 and the number examined 20. Subpectoral lymph nodes are regional nodes for breast primaries. 2003
20031085 Primary Site/Histology (Pre-2007): What are the correct site and histology codes for "tubal serous adenocarcinoma" identified in a fallopian tube? See Description. The pathology report of a laparoscopic left salpingo-oophorectomy states: 1.5 cm intraluminal mass left fallopian tube: micro: tubal serous adenocarcinoma, poorly differentiated, infiltrates the muscular wall of the fallopian tube; serosa does not appear to be penetrated. The left ovary is negative for malignancy.

For tumors diagnosed prior to 2007:

Code histology as 8441 [serous adenocarcinoma].

The primary site for this case is fallopian tube, not the suggested site code of ovary.

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.

 2003
20031078 EOD-Lymph Nodes--Colon: Are "multiple submucosal lymphoid collections infiltrated with tumor" or "lymphoid areas" coded as lymph node involvement, similar to the way nodules in the pericolic fat are coded? See Description. For an adenocarcinoma in the colon, under the "lymph node" section of the final path diagnosis it states "multiple submucosal lymphoid collections infiltrated with tumor" in addition to "one of two involved lymph nodes." The micro description states "There are multiple small lymphoid areas with tumor. A definite node excised from the mesentery shows...replacement of stroma and an additional very small node shows no tumor."

For cases diagnosed 1998-2003: No, do not code tumor infiltration of lymphoid collections or lymphoid areas as lymph node involvement.

However, code lymph node involvement for this case as 3 [mesenteric, NOS] because a mesenteric node is involved.

Regarding tumor infiltration of lymphoid collections or lymphoid areas from our pathologist consultant: Unless the anatomy of lymph node is evident (sinuses, trabeculae, primary and secondary follicles) these aren't lymph nodes and should not be coded as such. Unless there is evidence to the contrary in the path report, I would suggest that this be considered intramural spread, not lymph node spread.

 2003
20031202 Surgery of Primary Site--Head & Neck: How is this field coded for a surgery titled "Parotidectomy with facial nerve dissection"? See Description. If the operative report is not titled "total parotidectomy," can we assume that less than total parotidectomy was done? Can we assume that "facial nerve dissection" and "facial nerve monitoring" are other ways of stating "facial nerve spared"?

Use the best information available to determine whether or not all of the parotid has been removed. It is important to read the entire operative report and review the content of the pathology report. The Op report will usually include wording about how much was removed, and this can be confirmed by the path report. Do not make assumptions about the extent of the surgery based solely on the title used on the operative report.

For cases diagnosed 1998-2003: Code 30 [less than total parotidectomy] can be used when the parotid is not totally removed, but the exact type of partial parotidectomy cannot be determined. "Facial nerve monitoring" and "Facial nerve dissection" are synonymous with "facial nerve sparing."

 2003
20031194

Terms of involvement--Lung: Is "intense uptake" described on a PET scan an indication of involvement? See Description.

We are seeing increasing use of PET scans as diagnostic tools for cancer. PET scans use different terminology than the ambiguous terms listed in the EOD manual. Could we please have guidelines for interpreting PET scans?

Example: Patient with right lung cancer. PET scan showed intense uptake in the mediastinum and in the hilum. Can we code "intense uptake" as involvement of mediastinal and hilar lymph nodes?

 Do not interpret "intense uptake" as involvement. Look for a statement of involvement or other terminology, such as "highly suspicious," "strongly suspicious for" malignancy, involvement, etc. 2003
20031054 Grade, Differentiation: Is grade always coded to 4 for a diagnosis of Ewing's sarcoma?

Do not code the ICD-O-3 grade for Ewing sarcoma unless documented in the record.

In the TNM system, grade is required to place Ewing sarcoma into a stage group. For TNM staging purposes, Ewing sarcoma is classified as G4. Do not apply TNM rules to ICD-O coding.

 2003
20031084 Histology (Pre-2007)--Colon: What code is used to represent the histology "Adenocarcinoma, intestinal type?" See Description. The code 8144/3 is not valid for colon primaries. Should we code these as 8140/3 [Adenocarcinoma, NOS] or over-ride the error message?

For tumors diagnosed prior to 2007:

Code adenocarcinoma, intestinal type of the colon 8140 [Adenocarcinoma, NOS]. Do not use code 8144 for intestinal type adenocarcinoma in the colon.

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.

 2003
20031151 EOD-Size of Primary Tumor: Can size be coded from a needle bx that removes all of the invasive tumor and just leaves a "focus of in situ"? See Description. For example: needle bx diagnosis is "tiny focus of tissue highly suspicious for tubular ca." The lumpectomy path states "single focus of low grade DCIS, no residual ductal ca." Can size be coded 001? Code tumor size to 001 [Microscopic focus or foci only] for the invasive component. Code the tumor size 990 for cases diagnosed in 2004 and forward. Disregard the microscopic tumor found at further resection. 2003