First Course Treatment--Unknown & ill-defined site: We have a case with an unknown primary site and the patient had chemoembolization into the hepatic artery. We don't know how to code this treatment. See Discussion.
We were told to code as surgery (10) and chemo (01). However an unknown primary automatically gets a (98) surgery code & the chemo is coded (01) but we can't code as systemic therapy. This is an edit. Chemo coded but no date of systemic therapy.
Effective for cases coded prior to the change in policy made on January 9, 2008, code chemoembolization of a metastatic site as 1 [nonprimary surgical procedure performed] in Surgical Procedure of Other Site.
Surgery of Primary Site code 98 is assigned to all cases with an unknown primary.
In the case of a liver primary, it would be coded 10 [local tumor destruction, NOS] in Surgical Procedure of Primary Site.
2004 SEER Manual Errata/Grade--Colon/Bones: Is the term "pleomorphic" used to code tumor grade to 3 for selected primaries?
Delete the row containing the word "pleomorphic" from the tables on pages 93, C-219 and C-411. This correction will be included in the next set of replacement pages for the 2004 SEER manual.
CS Extension--Kidney: When an incidentally found 5 cm mass discovered on a CT scan during a work-up for colon carcinoma is stated to be consistent with renal cell ca, should the case be staged as localized or unknown when no other information is available related to a work-up for the kidney primary?
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 what is known. In the example above, the tumor size and the extension are known and can be coded. The information is limited, but not completely missing.
Code what you DO know rather than coding nothing. Any metastases from the kidney would have been discovered during the workup of the rectal cancer.
Reportability/Behavior--Thyroid: Does the term "invasion" indicate the presence of a malignant tumor? See Discussion.
Left thyroid lobectomy showed microfollicular neoplasm with evidence of minimal invasion. Micro portion of path report stated, "The capsular contour is focally distorted by a finger of the microfollicular nodule which appears to penetrate into the adjacent capsular and thyroid tissue."
We recommend that you contact the pathologist for further information. If no further information is available, do not accession this case based on the information provided. There is no definitive statement of malignancy.
If the case was sent to a consultant, there may be another opinion available. If there is information in the record, or the treating physician can be contacted, find out whether the tumor was benign or malignant and whether there was any further treatment.
According to our pathologist consultant, based only on the information above and nothing else, do not report since there is no diagnosis of malignancy.
CS Site Specific Factor--Prostate: Is there an established range of values that can be used to code negative, borderline or elevated PSA values? See Discussion.
Previous SEER prostate coding guidelines listed a PSA range that could be used to code negative, borderline, or elevated values in the absence of any statement concerning elevated PSA in the medical record. Is this still in effect for SSF 2, or do we need a definite statement when only a numeric value is given?
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 matter is under consideration by the CS Steering Committee. The CS Steering committee is reviewing options for incorporating SEER guidelines into the CS manual.
CS Lymph Nodes/Reg LN Pos/Exam: Is a final pathologic diagnosis of "Level 8 lymph node: Fibroadipose tissue containing a minute lymphoid aggregate, negative for malignancy" a lymph node for the purpose of coding these fields?
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.
Yes. "Fibroadipose tissue containing minute lymphoid aggregate" qualifies as a lymph node. Include in count as one lymph node examined in the example above assuming this is regional to the primary site.
2004 SEER Manual Errata/Grade--Breast: Are the codes on page 94 of the SEER manual's Breast Grading Conversion Table requiring conversion of nuclear grades 1/3 and 1/2 to code 1, 2/3 to code 2, and 2/2 and 3/3 to code 3 correct or are the codes on page C-473 in the Three-Grade System (Nuclear Grade) for breast correct that requires conversion of the same examples to codes 2, 3, and 4 respectively?
On page C-473: Delete the section titled "Three-Grade System (Nuclear Grade)" and delete the table. Use the tables on pages 94 and C-472 to code grade for breast cancer. This correction will be made in the next errata.
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