Reportability--Hematopoietic, NOS: Is the term "plasma cell dyscrasia" a synonym for multiple myeloma?
For cases diagnosed prior to 1/1/2010:
Plasma cell dyscrasia, NOS, is nonreportable. It is not a synonym for multiple myeloma. Plasma cell dyscrasia represents a broad spectrum of disease characterized by plasma cell proliferation that appears inappropriate or uncontrolled. Multiple myeloma is one disease type that falls into that classification. However, there are several other malignant and benign diseases also classified as such because of their immunoglobulin abnormalities. Reportability to SEER regarding a disease classified as a plasma cell dyscrasia is dependent on identifying the specific cell type associated with the disease in the ICD-O-3.
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.
Grade, Differentiation--All Sites: What code is used to represent this field when there are invasive and in situ components in a tumor, but only the in situ component is graded (e.g., Invasive ductal carcinoma with high grade ductal carcinoma in situ)?
Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable]. The grade is taken from the invasive component only.
Histology (Pre-2007)--Breast: Are diagnoses of "infiltrating duct and mucinous carcinoma" and "duct carcinoma, mucinous type" both coded to the histology code of 8523/3?
For tumors diagnosed prior to 2007:
Code "Infiltrating duct and mucinous carcinoma" to 8523/3 [Infiltrating duct mixed with other types of carcinoma] according to the instructions for coding a single tumor with complex histology in Appendix C of the 2004 SEER manual. Assign code 8523/3 when the diagnosis is duct carcinoma mixed with another type of carcinoma. Look for "and" or "mixed" in the diagnosis.
Code the Histology field for a "ductal carcinoma, mucinous type" to 8480/3 [Mucinous carcinoma].
The instructions for coding a single tumor with complex histology are to code the specific type if the diagnosis is "Duct carcinoma, _____ type."
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.
Histology (Pre-2007): Can adenocarcinoma in either a villous or tubulovillous polyp or adenoma be coded as histology for sites other than colon or rectum? See discussion.
When adenocarcinoma of the endometrium arises in a villoglandular polyp is the histology coded as 8263/3?
For tumors diagnosed prior to 2007:
Code the Histology field to 8263/3 [adenocarcinoma in a tubulovillous adenoma]. Histology codes 8261 [adenocarcinoma in a villous adenoma] and 8263 [adenocarcinoma in a tubulovillous adenoma] are used for non-colorectal sites when the cancer arises in a polyp.
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.
Grade, Differentiation--Unknown Site: Is grade coded to 9 [Cell type not determined, not stated or not applicable] for all unknown primaries?
Most unknown primaries would be coded to grade 9 [Cell type not determined, not stated or not applicable] in the Grade, Differentiation field unless the case is coded to one of the histologies for which the grade is implied, such as undifferentiated carcinoma, NOS [802034].
Chemotherapy--Hematopoietic, NOS: What treatment code is used to represent the drug "Gleevec" being used to treat chronic myelogenous leukemia?
For cases diagnosed 1/1/2003 and after: Code the Chemotherapy field to 02 [Single-agent chemotherapy administered as first course therapy]. It should be classified as a chemotherapy agent, albeit a unique one. Gleevec seems to work the same way many other chemo drugs do. It disrupts cell division for malignant cells containing the BCR-ABL protein only, rather than for normal and abnormal cells together. When the cells can't divide and create a new generation, they simply die. This meets the definition of an antineoplastic chemotherapy agent.
Reportability/Ambiguous Terminology/Date of Diagnosis: If a "suspicious" cytology is reportable only when a later positive biopsy or a physician's clinical impression of cancer supports the cytology findings, is the Date of Diagnosis field coded to the later confirmation date rather than to the date of the suspicious cytology? Is a suspicious "biopsy" handled the same way?
Cytology reported as "suspicious" is not reportable. If the physician confirms the suspicious cytology by making a clinical diagnosis of malignancy, the Date of Diagnosis field is coded to the date of the clinical diagnosis, which may or may not be same date the cytology was performed.
Without supporting clinical documentation, the case will remain non-reportable and will not be submitted to SEER. The supporting documentation can be a physician's statement that the patient has cancer, a scan or procedure that identifies cancer, or a positive biopsy.
Suspicious "biopsies" are reportable according to SEER's list of ambiguous terms. Suspicious "cytologies" without supporting clinical statements are not.
EOD-Clinical Extension--Prostate: Note 8 of the clinical EOD scheme for prostate states, "B1, Small, discrete nodule(s)<1.5 cm, and B2 Nodule(s)>1.5 cm ... " Does Note 8 still apply for cases diagnosed 1998 or later?
For cases diagnosed 1998-2003:
Note 8 in the EOD scheme does not apply because nodule size does not apply in the 5th or 6th edition of TNM.
EOD-Size of Primary Tumor--Corpus Uteri: If both the width and depth of the tumor are provided, do we code the largest dimension in the tumor size field? If the width dimension is not provided, can we code the depth of the tumor in the tumor size field? See discussion.
Example: An endometrial primary is described as having, "a soft lobulated tumor diffusely involving the entire endometrium, extending 2.0 cm into the myometrium."
For cases diagnosed 1998-2003:
Code the EOD-Size of Primary Tumor field to 999 [unknown] for this case because this field is supposed to reflect the dimension for tumor width and not tumor depth. Tumor depth is coded in the EOD-Extension field.
EOD-Size of Primary Tumor: How do you code tumor size for lesions described as "at least 2 cm"? See discussion.
The expression "at least 2 cm" seems to be different from "greater than 2 cm." Stating "at least" seems to indicate that if the tumor is larger than 2 cm, it is difficult to ascertain the exact tumor size. Should we accept 2 cm as the best info we have, or default to 999 because of the lack of specificity?
For cases diagnosed between 1998-2003:
Code the EOD-Size of Primary Tumor field to 020 [2 cm], using the rule "code what you know."
An official website of the United States government
Home