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Report Produced: 02/22/2026 15:58 PM

Report Question ID Question Discussion Answer Year
20031193 Surgery of Primary Site--Lung: Is a core-out of the main bronchus coded in this field? See Description. Patient with right lung cancer was not a surgical candidate because of extent of disease. Prior to receiving radiation, patient underwent bronchoscopy, which revealed obstruction from right main bronchial tumor. Core-out of the tumor was undertaken, and a specimen was sent for path evaluation. The physician stated that this was a palliative procedure to relieve obstruction.

Do not code bronchoscopy to clear the airway as surgery of primary site. When combined with laser therapy, cryosurgery, or other tumor destruction, or when combined with excision of tumor, code as surgery of primary site.

For cases diagnosed 1998-2003: Code surgery of primary site for the case described above to 23 [Excision, NOS]. Tissue was excised and sent to pathology.

 2003
20031080 Behavior Code/EOD-Extension--Bladder: How are these fields coded for a bladder tumor in which the pathologist states, "there is no definite invasion identified" but the urologist states the case as T1? See Description.

Patient presents with four bladder tumors, described as "each measuring close to 2 cm." A specimen was taken of only one of the tumors. The tops of the tumors were fulgurated, then vaporized methodically. No obvious tumor or residual was noted on re-inspection.

Pathology revealed papillary urothelial carcinoma, high grade, with no definite invasion identified. Small segments of muscularis propria were present. A comment read..."it is difficult to determine if lamina propria invasion is present due to marked necrosis and tissue fragmentation." Urologist staged this as AJCC cT2a, but based on the pathology findings changed it to cT1. The urologist insists this is invasive.

For cases diagnosed 1998-2003: Because of the damage to the specimen from cautery and the insistence of the urologist that the tumor was invasive, code extension for this case to 15 based on the physician's TNM category of T1.

A T1 is invasive--code the behavior /3. The urologist is confident it is invasive, and will likely treat the patient accordingly.

 2003
20031150 Histology (Pre-2007)--Breast: Should the histology "non-invasive papillary carcinoma" along with the comment "solid intraductal papillary proliferation includes cytologically atypical cells with scattered mitotic figures" be coded to 8503/2 [intraductal papillary carcinoma] or 8050/2 [papillary carcinoma in situ]?

For tumors diagnosed prior to 2007:

The best histology code for this breast case is 8503/2 [Noninfiltrating intraductal papillary carcinoma]. According to the WHO Classification of Tumors for Breast, Papillary carcinoma, non-invasive is a synonym for Intraductal papillary carcinoma. Further, code a more specific histologic type when found in the microscopic description, according to the SEER Program Code manual.

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.

 2003
20031141 Priorities/EOD-Lymph Nodes--Breast: Which part of the pathology report takes precedence when there is a discrepancy between the final path diagnosis and the CAP summary? See Description. For example, breast primary: Final path states "14/18 nodes (+) for tumor & separate matted aggregate of axillary nodes (+) for tumor. Subpectoral lymph node (+) for mets ca. Path Gross states "18 separate lymph nodes identified...many (+) for tumor grossly. Aggregate of matted lymph nodes within axillary tissue (+) for tumor. Multiple separate lymph nodes submitted." CAP Micro Summary lists "20/16 nodes examined/positive." What is correct number of nodes positive & nodes examined in this case? For cases diagnosed 1998-2003: The final pathology diagnosis has highest priority. The CAP summary is second priority. However, you always use the best information available. If the final path diagnosis is vague or unclear, information from the CAP summary can be used. In the case example, the total lymph node count from the final path diagnosis is unclear and the CAP summary provides clarification. Code the number of lymph nodes positive as 16 and the number examined 20. Subpectoral lymph nodes are regional nodes for breast primaries. 2003
20031073 EOD-Pathology Extension--Prostate: Is extracapsular extension implied by the phrase, "involvement of periurethral or urethral margins"? See Description. The prostatectomy final pathology diagnosis states that the tumor involves the periurethral margin. The microscopic describes involvement of the urethral margin. For cases diagnosed 1998-2003: Code the EOD-Extension field in the 20-34 range, which implies no extension beyond the prostate. Disregard involvement of periurethral margin or urethral margin, NOS, unless the pathologist or surgeon specifically mentions "extraprostatic urethra" involvement. 2003
20031004 Surgery of Primary Site--Skin: When would one use codes 30-33 for this field on a skin primary?

Surgery of Primary Site codes 30-33 under "skin" are used for various types of biopsies followed by a gross excision of the lesion. The two procedures (biopsy and gross excision) may be performed on different days, at different facilities, by different physicians as long as both procedures are performed during the first course of treatment.

Answer applies to both pre-2002 and 2003+ surgury code definitions.

 2003
20031148 EOD-Systemic Symptoms at Diagnosis--Lymphoma: Would the description, "three days of typical cold symptoms including congestion, sneezing, chills and advanced difficulty breathing and some fever" qualify as B-Symptoms?

For cases diagnosed 1998-2003:

Use the following criteria to determine whether or not certain clinical findings qualify as "B" symptoms.

1. Fevers. Unexplained fever with temperature above 38 degrees C.

2. Night sweats. Drenching sweats that require change of bedclothes.

3. Weight loss. Unexplained weight loss of more than 10% of the usual body weight in the 6 months prior to diagnosis.

Pruritus alone does not qualify for B classification, nor does alcohol intolerance, fatigue, or a short, febrile illness associated with suspected infections.

The clinical description in the example above does not meet the criteria for B symptoms. Generally, the symptoms in the B category have to occur over an extended period of 7 to 30 days. In this case the fever is explained by "typical cold symptoms" and in addition, three days of fever is not a long enough period.

 2003
20031201 Reportability/Terminology, NOS--Hematopoietic, NOS: Are the diagnoses "myelodysplastic syndrome," "myelodysplastic syndrome, thrombocytopenia" and "myelodysplastic syndrome, anemia" all reportable to SEER for diagnosis 2001 and later?

For cases diagnosed prior to 1/1/2010:"Myelodysplastic syndrome" (NOS) is reportable to SEER--ICD-O-3 code 9989/3. "Myelodysplastic syndrome, thrombocytopenia" is not reportable to SEER because "thrombocytopenia" is not reportable. "Myelodysplastic syndrome, anemia" is not reportable to SEER because "anemia" is not reportable.

For cases diagnosed 2010 forward, 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.

 2003
20031035 Reportability/Histology--Hematopoietic, NOS: Does the presence of sideroblasts on a bone marrow biopsy confirm a diagnosis of refractory anemia with sideroblasts?

Final path diagnosis of bone marrow biopsy:

I. Hypercellular marrow for age with trilinear hyperplasia.

II. Decreased iron stores with decreased sideroblasts.

Comment: Although the overall picture is not diagnostic of a specific entity, it is most consistent with an early stage myelodysplastic syndrome which would best be considered refractory anemia at this point.

In this case the percentage of sideroblasts is not stated. Would the path diagnosis of "decreased sideroblasts" along with the path comment of "refractory anemia" indicate that this case should be coded to 9982/3 [Refractory anemia with sideroblasts]?

For cases diagnosed prior to 1/1/2010:

For the hematologic diseases, do not accession the case unless there is a definite positive diagnosis. A positive diagnosis, such as "Refractory anemia" must be stated in order to code that diagnosis. Other words associated with the positive diagnosis, such as "sideroblasts" are NOT to be used alone to assume a diagnosis.

Decreased sideroblasts does not make a diagnosis of Refractory anemia with sideroblasts. The sideroblasts for 9982/3 [Refractory anemia with sideroblasts] are characteristic in rings, and are INCREASED to make the diagnosis.

Based on the information provided, this case is not reportable. The final path diagnosis is not a reportable disease. The comment further states that the overall picture is not diagnostic of a specific entity. Therefore, it should not be reported at this point.

For cases diagnosed 2010 forward, 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.

2003
20031056

Multiple Primaries (Pre-2007)--Breast: For a patient with a remote history of lobular breast carcinoma, would a new diagnosis of lobular breast carcinoma with DCIS be a new primary, even though the physician designates it as recurrent? See Description.

A history of right breast lobular ca in 1991 treated with a partial mastectomy. Diagnosed 3/02 with "recurrent right breast ca" per physician; pathology in 2002 is lobular and DCIS.

Would the DCIS make this a new primary regardless of the physician's designation of 'recurrent' or is this the same primary?

For tumors diagnosed prior to 2007:

Accession as two breast primaries -- the first lobular ca in 1991; the second lobular and DCIS in 2002.

The differing histologies and the length of time between them negate the physician's designation as "recurrent" in this case.

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.

 2003