Histology (Pre-2007)--Melanoma: How is a 2004 "malignant melanoma, nodular type, epithelioid cell type" coded?
For tumors diagnosed prior to 2007:
Assign code 8771 [Epithelioid cell melanoma]. Code the cell type when specified.
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.
CS Site Specific Factor/Terminology--Breast: Does the term "focal areas" of in situ carcinoma qualify as "minimal" in situ component when coding SSF6 field (assessment of the invasive and in situ components present) in the CS breast scheme?
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, the term "focal areas" of in situ carcinoma describes a minimal in situ component.
CS Site Specific Factor--Prostate: Are the EOD guidelines developed for coding apex involvement still in effect for determining the code for apical involvement in SSF 4? See Discussion.
How do the old prostate codes 31, 33, and 34 correspond to the new SSF 4 field? Because "arising in" or "extending into" apex is rarely, if ever, stated, previous SEER guidelines instructed us to use code 33 for "apex only" involvement, and code 34 for "apex and any other area of prostate". Code 31 [into/arising, NOS] was to be avoided.
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.No, the EOD guidelines for coding apex involvement are not in effect for coding SSF4.
The codes for CS site specific factor 4 include code 2 [into prostatic apex/arising in prostatic apex, NOS]. When it cannot be determined if apical involvement is arising in, or extending to, the apex, use code 2.
Histology (Pre-2007)--Ovary: What codes are used to represent "mixed papillary serous and clear cell carcinoma" and "papillary serous carcinoma with focal clear cell features" of the ovary?
For tumors diagnosed prior to 2007:
Assign code 8323 [Mixed cell adenocarcinoma] to "mixed papillary serous and clear cell carcinoma." This is histology coding rule 3 in the 2004 SEER manual under single tumor (page 86). There is no other code for this mixture.
Example 1: 8323
Example 2: 8461 (clear cell is not coded according to Rule 6, page 87, because it is not the majority of the tumor).
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.
CS Lymph Nodes/Scope of Regional Lymph Node Surgery--Prostate: When prostate cancer is an incidental finding at cystoprostatectomy for bladder cancer, is the pelvic lymph node dissection coded for the prostate as well as the bladder?
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, the pelvic lymph node dissection is coded as regional lymph node surgery for both primaries and the nodes are counted in collaborative staging for both primaries. The examination of the pelvic lymph nodes is relevant to both the bladder and the prostatic primaries.
CS Site Specific Factor--Prostate: Explain the difference among SSF4 prostate codes 150 [No clinical involvement of prostatic apex & prostatectomy apex extension unknown], 510 [Clinical involvement of prostatic apex unknown & No prostatectomy apex extension], and 550 [Clinical involvement of prostatic apex unknown & prostatectomy apex extension unknown].
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.Site Specific Factor 4 captures the status of clinical apex involvement and prostatectomy apex involvement. The first digit in codes 110-550 indicates the clinical status of apex involvement. The second digit indicates apex involvement found at prostatectomy. The third digit is always zero. For both first and second digits, the codes and definitions are the same:
1 - No involvement of prostatic apex
2 - Into prostatic apex/arising in prostatic apex, NOS
3 - Arising into prostatic apex
4 - Extension into prostatic apex
5 - Apex extension unknown
Code 150 = No clinical involvement of prostatic apex & prostatectomy apex extension unknown
Code 510 = Clinical involvement of prostatic apex unknown & No prostatectomy apex extension
CS Eval--Ovary: How is CS Mets Eval coded when the patient has positive pleural effusion confirmed by cytology?
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 CS Mets Eval for the example above 3 [path exam of metastatic tissue] assuming there has been no pre-treatment. Positive cytology is required for confirmation of pleural effusion for an ovarian primary.
Collaborative Staging--Hematopoietic, NOS: Which Collaborative Staging schema is used for a connective, subcutaneous and soft tissue primary of the pelvis [C495] with the morphology of Langerhans cell sarcoma [9756/39]? See Discussion.
On page C-411 of the SEER manual for the connective, subcutaneous, and other soft tissues schema it lists exceptions for certain morphologies and the above is not listed as an exception. On the Hematopoietic scheme it lists the above morphology.
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.Use the hematopoietic schema on page C-709 of the 2004 SEER manual. The histologically defined schemas have priority over the site schemas when both apply. See page 115 of the 2004 SEER manual.
The morphology codes listed on page C-411 pertain to the SEER Site Specific Guidelines.
Reportability: Are malignant tumors of genital skin reportable? On page 1 of the 2004 SEER Manual, Reportable Diagnoses, 1.b.i. Exceptions: malignant and invasive histologies not required by SEER - Skin. There is no longer a note that states that lesions ARE reportable for skin of the genital sites. Has SEER discontinued the collection of malignant skin tumors of the genital sites OR is the manual in error?
The histologies listed in the exception on page 1 are NOT reportable when the topography code is C440-C449. The manual specifically lists the topography codes in 1.b.1. Diagnoses with the listed histologies ARE reportable when the topography code is NOT C440-C449. Genital skin sites are not coded C440-C449 so a note is not needed.
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