Report | Question ID | Question | Discussion | Answer | Year |
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20071083 | MP/H Rules/Multiple Primaries--Bladder/Renal Pelvis: Is a non-invasive papillary transitional cell carcinoma of the bladder diagnosed one year after the occurrence of an invasive papillary transitional cell carcinoma of the renal pelvis reported as one or two primaries? | For cases diagnosed 2007 or later: This is a single primary with renal pelvis as primary site. Use the 2007 MP/H rules to determine if the 2007 diagnosis is a new primary. Use the Urinary rules, multiple tumors module. Start with rule M3. Follow the rules down to Rule M8 and stop. This is an example of implantation effect. |
2007 | |
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20071062 | Primary Site: For malignant gastrointestinal tumors (GISTs), how should the primary site be coded and which Collaborative Stage and TNM staging schemes should be used for disease found in the stomach, small intestine or other locations? | 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 the primary site to the location where the GIST originated. If the primary site cannot be determined, assign code C809 [Unknown primary site].
GIST of gastrointestinal hollow viscera cannot be staged in TNM. In Collaborative Staging, use the stomach scheme for GIST of the stomach. Use the small intestine scheme for GIST of the small intestine. For GIST of other primary sites, use the CS scheme for the specific site. |
2007 | |
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20071097 | Multiplicity Counter--Thyroid: How is multiplicity counter to be coded for a thyroid cancer presenting as multiple foci? See Discussion. | Thyroidectomy showed papillary thyroid carcinoma. Path diagnosis: tumor focality: multifocal. Path described 3 foci of tumor on each side. The main tumor mass in right thyroid was 1.5 cm. Smaller foci of tumor ranged in size from .1 cm to 1.0 cm. Per guidelines, "we still don't count foci as tumors for the purpose of these rules, even if there is more than one." The 1 cm tumor was probably macroscopic in size. Do we count it in the multiplicity counter? Do we count only the 1.5 cm main tumor mass? | If the number of tumors is known, code the number in Multiplicity Counter. If foci are measured, include them in the multiplicity counter. If the only information available is "multiple foci" assign code 99. For the case above, code 06 in the multiplicity counter (3 tumors on each side). |
2007 |
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20071044 | Date of Conclusive Terminology: Is there an applicable timeframe when coding this field? |
There is no strict timeframe for Date of Conclusive Terminology. The diagnosis using conclusive terminology could be made any time following the diagnostic work-up. The date of conclusive terminology is related to code 2 [ambiguous term followed by conclusive term] in the data item "Ambiguous terminology." Assign code 2 when a conclusive diagnosis is made 60 days or more after a diagnosis using ambiguous terminology. Record the date of the conclusive diagnosis in "Date of Conclusive Terminology." |
2007 | |
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20071043 | Multiplicity Counter: Are in situ tumors diagnosed more than 60 days after invasive tumors of the same site and histology included in the Multiplicity Counter? | If an in situ tumor following an invasive tumor is a single primary according to the multiple primary rules for that particular site, include the in situ and the invasive tumors in the multiplicity counter. | 2007 | |
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20071010 | MP/H Rules/Histology--Prostate: While cases of "acinar adenocarcinoma" of the prostate are required to be abstracted with the histology code 8140/3 [adenocarcinoma, NOS] for cases diagnosed 1/1/07 or later, can 8550/3 [acinar adenocarcinoma] be used for cases diagnosed prior to 1/1/07? See Discussion. | The SEER Multiple Primary and Histology manual, effective with 2007 forward diagnosis dates, indicates that this histology should be coded to 8140/3 [adenocarcinoma, NOS]. Does this contradict ICD-O-3? Can acinar adenocarcinoma be coded for other primary sites? | For cases diagnosed 2007 or later, code acinar adenocarcinoma of the prostate as 8140/3. Prior to diagnosis year 2007, code 8550/3 [acinar adenocarcinoma] may be used for prostate cases and for acinar adenocarcinoma of other sites, such as pancreas. |
2007 |
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20071114 | Ambiguous Terminology/Date of Diagnosis: How would you code the diagnosis date when the body of an imaging report uses reportable ambiguous terminology while the final impression in that same report uses non-reportable ambiguous terminology? Would you code the diagnosis date to the date of the scan or to the subsequent biopsy date that confirmed a malignancy? See Discussion. | Within the body of a mammogram report, the radiologist stated, "diffuse inflammatory tissue throughout the rt breast w/ large rt axillary lymph nodes, consistent with an inflammatory carcinoma of rt breast." His final impression, however, said "extremely suspicious rt breast w/ extremely dense breast parenchyma and adenopathy in axilla, suggesting an inflammatory carcinoma." The patient then went on to have a biopsy, which was indeed positive for cancer. | Accept the reportable ambiguous terminology from the body of the mammogram. Record the date of the mammogram as the date of diagnosis. The guidelines on page 4 of the 2007 SEER manual addressing discrepancies within the medical record can be applied to discrepancies within one report. The instructions are: If one section of the medical record(s) uses a reportable term such as apparently and another section of the medical record(s) uses a term that is not on the reportable list, accept the reportable term and accession the case. |
2007 |
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20071041 | Reportability/Chemotherapy--Hematopoietic, NOS: Is pyridoxine-responsive sideroblastic anemia (SA) reportable and is pyridoxine coded as chemotherapy for SA and refractory anemia with ringed sideroblasts (RARS)? See Discussion. |
Patient has refractory anemia with ringed sideroblasts on bone marrow path. The physician mentions it might be due to pyridoxine deficiency. Per the SEER*Rx, pyridoxine (aka Vitamin B6) is not coded as treatment. What causes RARS and SA? Is pyridoxine treatment for either disease process? Or is the pyridoxine just treating one aspect of the anemia? The patient has no other treatment but this. |
For cases diagnosed prior to 1/1/2010:Sideroblastic anemia (SA) is not reportable. SA is not the same as refractory anemia with ringed sideroblasts (RARS). Therefore, do not code pyridoxine administered for SA as therapy. If the patient had RARS that "might be due to pyridoxine deficiency," the replacement pyridoxine would not be coded as chemotherapy because it does not control or kill malignant cells. If the pyridoxine was successful in alleviating the refractory anemia, the RARS would be reversible and would not meet the criteria for a reportable blood disease; i.e. irreversible, clonal. 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. |
2007 |
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20071025 | Radiation Therapy: How is radiation coded when it is "recommended" but the patient dies before radiation is started? See Discussion. | Code 0 seems appropriate but then we would lose the fact that it had been recommended. All of the other modalities give an option for 'recommended but patient died prior to treatment.' Is there a reason this option is not given for radiation? | Code Radiation (Rx Summ--Radiation) to 0 [None; diagnosed at autopsy].
SEER does not collect the Reason For No Radiation field. However, those who abstract using software that captures this data item can identify these cases. Code 5 [radiation not administered because patient died] reflects this situation.
Radiation (Rx Summ-Radiation) is a SEER field. This field is derived from the data collected in Rad-Boost Rx Modality and Rad-Regional TX Modality. These fields do not include a choice for "radiation not given because the patient died prior to treatment." Therefore, this information cannot be coded in the Radiation field. |
2007 |
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20071051 | MP/H Rules/Multiple Primaries--Lung: Please clarify the multiple primary rule M6 and the explanatory note that states when there is a single tumor in each lung, they are to be reported as multiple primaries unless stated or proven to be metastasis. See Discussion. | Single tumor in left lung, single tumor in right lung. The rules take you to M6. Suppose the tumor in left lung is biopsied and there is a physician statement that right lung tumor is metastatic from left lung tumor. The note under M6 is "When there is a single tumor in each lung, abstract as multiple primaries unless stated or proven to be metastatic." In this case, is it a single primary or multiple primaries? | For cases diagnosed 2007 or later: When there is a single tumor in one lung and a single tumor in the other lung, apply rule M6 and abstract as multiple primaries. Use this rule whenever there is a single tumor in each lung, even when neither tumor is biopsied or resected.
This rule is unique to lung. Our physician advisors emphasized that it is very unlikely that a single tumor in one lung could be metastatic from a single tumor in the opposite lung. Therefore, the default is to abstract as multiple primaries.
The note at M6 means that there must be proof that one tumor is metastatic in order to abstract as a single primary. For example, a biopsy of the tumor proving that it is metastatic. An opinion or belief that one tumor is metastatic is not sufficient. In the absence of proof, use rule M6 and abstract as multiple primaries.
A list of MP/H clarifications will be available. This issue will be included on the list. |
2007 |