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Report Produced: 11/07/2024 11:33 AM

Report Question ID Question Discussion Answer Year
20081037 Extension/CS Extension--Prostate: Do the prostate guidelines used for EOD still apply to cases diagnosed 2004 forward?

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.For cases diagnosed 2004 and forward, refer to the Collaborative Staging manual.

The 2004 CS guidelines have been agreed upon by all standard setters and have been reviewed by the COC/AJCC urologists.

Note: Do not use the SEER EOD guidelines with Collaborative Staging.

 2008
20081068 Scope Regional LN Surgery--Melanoma: How is this field coded when there is no primary skin lesion and the only disease present is one axillary lymph node that reveals melanoma? See Discussion. According to SINQ 20061045, the CS Lymph Node field is coded to 80. Code scope of regional LN surgery 4 [1 to 3 regional lymph nodes removed] for this case. One lymph node was removed. For this case, the axillary lymph node is coded as regional for the CS Lymph Node field. Therefore, include this lymph node is also coded in the Scope of Regional LN Surgery field. 2008
20081051 MP/H Rules/Histology--Prostate: Path said adenocarcinoma of the prostate with an endometroid adenocarcinoma component. What histology code is used?

For cases diagnosed 2007 or later:

Assign code 8500 [duct carcinoma].

According to The World Health Organization (WHO), the term endometrioid carcinoma of the prostate is now called Prostate Duct Carcinoma.

Using Rule H11 (one type), code 8500 (duct carcinoma) for this rare type of tumor. Do not stop at Rule H10 because this is not acinar.

 2008
20081046 MP/H Rules--Corpus uteri: How is histology coded for an endometrial tumor described as an "endometrioid adenocarcinoma with prominent squamous metaplasia"?

For cases diagnosed 2007 or later:

Endometrioid adenocarcinoma with squamous metaplasia is coded 8570 [Adenocarcinoma with squamous metaplasia]. This falls under the Histology Coding Rules for Other Sites, rule H17. The code for Endometroid adenocarcinoma is 8380. The code for Adenocarcinoma with squamous metaplasia is 8570. The histology with the numerically higher ICD-O-3 code is Adenocarcinoma with squamous metaplasia -- 8570.

 2008
20081119

Reportability/Date of diagnosis--Liver: Does the final diagnosis of a scan have higher priority than the findings in the discussion in the body of the report? See Discussion.

A patient with liver cancer becomes transplant eligible when the tumor is 2 cm in size. Frequently, liver tumors will be watched (no biopsy) for months until they meet the 2 cm size criteria. In the meantime, multiple scans will describe the tumor using variations of ambiguous terms that drift in and out of reportablility. One day the tumor is labeled "presumed hepatocellular carcinoma." Weeks later it is back to "worrisome for hepatoma." A single scan will use different terms in different sections of the report.

Example case: Abdominal CT reveals a 1 cm liver lesion. Per the discussion portion of the scan, the lesion is consistent with hepatocellular carcinoma. Per final diagnosis: 1 cm liver lesion, possibly hepatocellular carcinoma. Is this report diagnostic of cancer? Would the date of this report be the date of diagnosis? (Patient did receive a liver transplant for hepatocellular carcinoma months later.)

When a reportable ambiguous term is used in one part of a report or the medical record and a non-reportable ambiguous term is used in another part of the report or the medical record, accept the reportable term and accession the case.

The example above is reportable. "Consistent with" is a reportable ambiguous term. Accept "consistent with" over the non-reportable term "possibly."

The date of this report would be the date of diagnosis if this is the earliest report using reportable terminology.

 2008
20081090 MP/H Rules: Does the presence of metastases affect the application of the MP/H rules? See Discussion. Single lung tumors presenting in each lung but the patient also presents with bone mets? Would rule M6 apply? Or do the bone mets represent additional tumors?

For cases diagnosed 2007 or later, the MP/H rules do not apply to metastases. Ignore metastases when applying the rules.

For the case above, use rule M6 and abstract as two primaries (right lung and left lung). The bone mets are ignored.

 2008
20081063 MP/H Rules--Breast: How many primaries should be abstracted when a patient has a mass at 6:00 that showed poorly differentiated ductal carcinoma and a hypoechoic nodule at 9:00 that was excised with no real tumor present there though path showed angiolymphatic invasion by carcinoma throughout the entire specimen? See Discussion.

Palpable mass in right breast at 6:00. Path stated 'poorly differentiated ductal carcinoma with extensive necrosis and extensive angiolymphatic invasion. Focal high grade comedocarcinoma (1%)'. Another hypoechoic nodule was seen at the 9:00 position. This mass was excised from surrounding tissue. This mass was more like an inflammatory mass; there was no real tumor present there. Path report stated "Breast mass 9:00 excisional biopsy - angiolymphatic invasion by mammary carcinoma throughout the entire specimen."

Is this two primaries because of the two different histology codes: 8500 and 8010?

 For cases diagnosed 2007 or later, abstract as a single primary using rule M3 (a single tumor is always a single primary). There was one tumor present according to the information provided. The second specimen was not a separate tumor ("There was no real tumor present there"). 2008
20081023 Histology: Must every word in the ICD-O-3 code definition appear in the diagnosis in order to assign that ICD-O-3 code? See Discussion. Is the diagnosis "Acute myeloid leukemia, M2" coded to Acute myeloid leukemia with maturation, FAB M2, NOS, (9874/3) or to Acute myeloid leukemia, NOS, (9861/3)?

For cases diagnosed prior to 1/1/2010:The general instructions for assigning histology codes are to code as precisely as possible. Acute myeloid leukemia with maturation is the definition of the FAB M2 category. A pathologist does not need to provide every word in the term associated with an ICD-O code; pathologists don't always talk that way. AML M2 is a very specific diagnosis and should be coded to 9874/3.

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.

2008
20081107 Multiplicity Counter/Ambiguous terminology: How should these fields be coded for cases with an unknown date of diagnosis? If the date of diagnosis is unknown, it is likely that you have little information for this case. Both multiplicity counter and ambiguous terminology fields would probably be coded as unknown. However, if information on the number of tumors and the diagnostic confirmation are available, code these fields as specified in the manual. 2008
20081080 CS Lymph Nodes/CS Site Specific Factor--Head and Neck: How should these fields be coded when the information is from an out of state data exchange and the record provides no supporting text, all the required fields are not coded and the codes that are provided are in conflict? See Discussion. A parotid case with CS LN coded to 10 [single positive ipsilateral regional node]; Regional LNs Positive coded to 68 and Regional LNs Examined coded to 74. No SSFs were coded. Based on the number of nodes coded as positive, the CS LN code was incorrect. Because the only information available to the central registry was that multiple regional LNs NOS were positive, we coded CS LN to 80 [lymph nodes NOS] and coded all SSFs to 999. Upon running the SEER edits, this case popped up on edits yielding a CS Site-Specific Factor codes, CS Lymph Nodes and Head/Neck Schemas conflict. Provide some guidance as how to properly code CS LNs & SSFs 1-6 for this case given the very limited information provided to us?

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.This is an unusual situation with conflicting information. If possible, request the pathology report and/or audit the case.

If you cannot obtain any further information or clarification, there are two choices:

  • Code CS LN's 80; code SSF 1 & 2 999, code SSF 3-6 000.

  • Code CS LN's 99; code SSF 1-6 999.

    		•  2008