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Report Produced: 09/11/2025 15:21 PM

Report Question ID Question Discussion Answer Year
20041046

CS Tumor Size--Breast: When the diagnosis is inflammatory carcinoma of the breast, must the CS tumor size always be 998? See Discussion.

I have no specific example of a situation; I am writing an edit check and wondering if there would be any exceptions to this rule.

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. For inflammatory carcinoma, code the size of the tumor in CS tumor size. Use code 998 [diffuse] when the tumor is stated to be "diffuse."

Page 27 in Part I of the CS manual will be corrected to define code 998 for breast as only "diffuse." The errata should be distributed in July 2004.

 2004
20041092 CS Extension--Bladder: How would the following statements be coded for bladder extension -- Code 03 [inferred description of non-invasion] vs code 15 [invasive confined to subepithelial connective tissue]. See Discussion.

1) no smooth muscle invasion

2) no muscle invasion

3) without muscle invasion

4) no invasion of muscularis propria

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 in 2004 and later code CS extension:

1) no smooth muscle invasion -- 15

2) no muscle invasion -- 15

3) without muscle invasion -- 15

4) no invasion of muscularis propria -- 03

 2004
20041099 First Course Treatment: If a patient makes a blanket refusal of all recommended therapy or refuses all treatment before any therapy was recommended, are only immunotherapy and hematologic/endocrine therapies to be coded as refused (code 87)? Or should all treatment modalities be coded as refused if a patient makes a blanket refusal? Or should none of the treatment modalities be coded as refused because we do not know what would have been recommended? See Discussion. Coding instructions for immunotherapy and for hematologic/endocrine procedures state that Code 87 is to be assigned if either of the following circumstances apply: 1) If the patient made a blanket refusal of all recommended treatment. 2) If the patient refused all treatment before any was recommended. These instructions are not included for other treatment modalities. When the patient refuses treatment, the first course of therapy is no treatment. Code all treatments as refused. 2004
20041077 CS Site Specific Factor 1--Colon: If the registrar did not support the CEA code recorded with the appropriate text documentation, should the central registry accept the registrars coding or change the value to 999?

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.Accept your registrars' codes at your discretion. It is encouraged, but not required, to enter text for CS data elements. These cases do not automatically default to code 999.

 2004
20041006 Multiple Primaries (Pre-2007)/Date of Diagnosis--Bladder: How is date of diagnosis coded when metastases consistent with a bladder primary are found more than a year after a diagnosis of non-invasive bladder cancer? See Description. A non-invasive papillary transitional cell carcinoma is removed by TURB in May 2002. In January 2003, a bone biopsy reveals metastatic transitional cell carcinoma consistent with bladder primary.

For tumors diagnosed prior to 2007:

Code a second bladder primary diagnosed in January 2003.

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.

 2004
20041103 Histology (Pre-2007)/Behavior Code/Sequence Number-Central -- Ovary: How are these fields coded for a "serous tumor of low malignant potential" when lymph nodes are discovered to be involved?

For tumors diagnosed 2001-2006:

This ovarian tumor is not SEER reportable if diagnosed between 2001-2006. The histology and behavior codes are 8442/1 [serous cystadenoma, borderline malignancy]. Sequence is coded appropriately from 60-88 [non-malignant tumor or central registry-defined neoplasm].

The behavior code could be changed to /3 only when the pathologist states that the disease is malignant. Approximately 20% of serous tumors of low malignant potential have lymph node involvement, according to the WHO Classification of Ovarian Tumours. In ovarian serous tumors of low malignant potential, lymph node involvement is not always equivalent to metastasis and does not signify malignancy in these tumors unless definitely stated as such by the pathologist.

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.

 2004
20041063 Primary Site/Histology (Pre-2007)--Mediastinum: How do we code these fields for a case described as a "neuroendocrine carcinoma" of the "anterior mediastinum" without failing the SEER "impossible" site/histology combination edit? See Discussion. Two different facilities state that the patient has "neuroendocrine carcinoma of the anterior mediastinum." This coded combination failed SEER edit (SEERIF38). We can not correct it because that edit flag does not appear on our system. Both facilities indicate that the mediastinum is the primary. In addition, there is text to support both the histology and primary site codes.

For tumors diagnosed prior to 2007:

The combination of C381 [anterior mediastinum] and 8246 [neuroendocrine carcinoma] will be removed from the list of "impossible" site/histology combinations. There are rare cases of neuroendocrine carcinoma of the anterior mediastinum. As illustrated in the discussion, verify that the primary site is anterior mediastinum, the histology is neuroendocrine ca, and document those findings in the text.

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.

 2004
20041018 Grade, Differentiation: Can grade be assigned based on a thin prep if there is no grade in the other pathology reports? See Discussion.

Example:

Vag & Cervical Thin-Prep: Adenocarcinoma, endometrial, high grade.

Resected Uterus and Left Adnexa: Endometrial papillary serous carcinoma arising in an endometrial polyp.

 When it is the only source specifying the grade, code grade from the thin prep. 2004
20041001

Histology (Pre-2007)--Pancreas: Should pancreatic neoplasia III (PanIN III) be coded to 8010/2 [carcinoma in situ, NOS] or 8500/2 [Ductal carcinoma in situ]? See Description.

There is no specific morphology code for PanIN-III in the ICD-O-3. In the chapter for exocrine pancreas found in the sixth edition of AJCC cancer staging manual, pg 160, reference is made to PanIN-III and its inclusion with carcinoma in situ.

For tumors diagnosed prior to 2007:

Code PanIN-III (pancreatic intraepithelial neoplasia III) as 8500/2 [Ductal carcinoma in situ, includes DIN 3: Ductal intraepithelial neoplasia 3]. PanIN-III is a synonym for carcinoma in situ according to the WHO classification of Tumors and the College of American Pathologists' Protocol for exocrine pancreas. Do not code PanIN-I or PanIN-II as cancer.

For tumors diagnosed 2007 or later, see SINQ 20110081 and 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.

2004
20041090 CS Extension/CS Mets at Dx--Lung: How are these fields coded for bilateral pleural effusion for a right lung primary? A code of 72 in the CS Extension field leads to a T4, but bilateral pleural effusion is M1. Should CS Mets at Dx be coded 39?

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 bilateral malignant pleural effusion, code the ipsilateral malignant effusion in CS Extension and the contralateral malignant effusion in CS Mets at Dx. Assuming the bilateral pleural effusion is the furthest extension in this case, code CS Extension to 72 [Malignant pleural effusion]. Code CS Mets at Dx to 40 [Distant mets, NOS].

 2004