Report | Question ID | Question | Discussion | Answer | Year |
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20031110 | Primary Site/Reportability--Head & Neck (Lip): Should basal cell or squamous cell carcinomas of "lip, NOS" be coded as reportable to C00_ [Lip] or to C440 [Skin of Lip, NOS], and therefore be non-reportable to SEER? |
Basal cell carcinoma of lip, NOS is coded to C440 [skin of lip] because basal cell starts on skin cells, not mucous membrane. Basal cell carcinoma of the skin (except for genital sites) is not reportable to SEER. Squamous cell can be either skin or vermillion of lip. Read the pathology report. If the squamous cell lesion is overlapping skin and vermillion, go with the area of greatest involvement. If more than 50% of the lesion is on the vermillion, code to the vermillion [C00__] and it is reportable to SEER. |
2003 | |
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20031071 | EOD-Extension--Brain and CNS: How does one code this field for a brain primary with drop metastases and/or seeding? See Description. | In the past SEER has advised coding these cases to extension 60. However, SS2000 states to code these cases to distant.
1. Primary in the cerebrum, hypothalamic region, with drop mets to spinal cord. 2. Primary in the cerebellum with spinal cord drop mets. 3. Primary in the fourth ventricle, with drop mets along the spinal cord. |
For cases diagnosed 1998-2003: Assign extension code 85 [Metastasis] for drop metastases and/or seeding of the spinal cord from a brain primary. Assign code 85 to each of the three cases above. |
2003 |
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20031116 | EOD-Size of Primary Tumor: Can the term "filling defect" be used to code tumor size? See Description. |
Site: Bladder CT abd/pelvis: 4 cm filling defect of the bladder encasing jetstream of distal ureter. 2-3 cm lesion may be extension to bladder. KUB: 3-4 cm filling defect within bladder. Cystoscopy: large bladder tumor with small tumor extending out of the large tumor. OP Findings: Large tumor on right of bladder extending from bladder neck lateral and posterior Pathology: TURB: High grade TCC, Grade III with focal lamina propria invasion. |
For tumors diagnosed 1998-2003:
Information on size from imaging/radiographic techniques can be used to code size when there is no more specific size information from a pathology or operative report, but it should be taken as low priority, just above a physical exam. The term "filling defect" from a CT or KUB may be used to code tumor size for bladder in the absence of more reliable size information from path, operative or endoscopic reports. |
2003 |
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20031045 | Other Therapy: How do we classify "thalidomide" when it is given as cancer directed therapy? | Code to the appropriate code (1, 2 or 3) under Other Therapy, depending on whether the drug was given as part of a clinical trial. If not part of a clinical trial, assign code 1 [Other cancer-directed therapy]. Thalidomide is not FDA approved for treating cancer. It is under investigation for anti-angiogenesis effects in different cancers. |
2003 | |
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20031187 | Histology--Lymphoma: What code is used to represent the histology "monomorphic post-transplant lymphoproliferative disorder [diffuse large B-cell lymphoma]"? See Description. |
A 14 year old with a cadaver kidney transplant in 1994 for membranous glomerulonephritis presented in 6/26/03 with a right cervical LN with biopsy showing "lymph node involved by monomorphic post-transplant lymphoproliferative disorder (diffuse large B-cell lymphoma). Staging was done including a bone marrow which was negative, CSF negative. The oncologist on the case reduced the immunosuppression drugs with the final outcome being no sign of the lymphoma. | For cases diagnosed prior to 1/1/2010:Code 9680/36 [Diffuse large B-cell lymphoma]. This post-transplant lymphoproliferative disorder was diffuse large B-cell lymphoma. According to the World Health Organization, there are two types of post-transplant lymphoproliferative disorder. "Regular" post transplant lymphoproliferative disorder is not a neoplasm and is therefore not reportable to a cancer registry. The second type (sometimes called Hodgkin-like PTLD) is classified as a B-cell lymphoma, which means that it IS 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 |
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20031100 | Date of diagnosis: Can a positive VMA:HVA test be used as a date of diagnosis for neuroblastoma? See Description. |
Rubin's Clinical Oncology states: Both the catecholamines and their metabolites are used as markers for neuroblastoma, with vanillylmandelic acid (VMA) and homovanillic acid (HVA) being the most commonly used. While their absolute values are not of prognostic significance, a higher VMA:HVA ratio suggests a better prognosis for patients with disseminated disease. |
Updated answer July 2024 No. Do not code the neuroblastoma diagnosis date from only the date of an elevated urine catecholamine test (VMA or HVA). Neuroblastoma diagnosis should be made on the basis of tissue biopsy or bone marrow aspiration along with elevated urinary catecholamines. Elevated urinary catecholamines alone are not diagnostic of neuroblastoma. |
2003 |
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20031066 | Histology (Pre-2007): Is 8524 [lobular mixed with other carcinoma] or 8490 [signet ring cell carcinoma] used to represent a diagnosis of "infiltrating lobular with signet ring features?" | For tumors diagnosed prior to January 1, 2004:
According to our pathologist consultant, for this specific case, code to 8490 [Signet ring cell carcinoma].
Our pathologist states: "Signet ring cell carcinoma is most often a variant of lobular carcinoma (as it appears to be in this case - it is less frequently a variant of ductal), and I think it's appropriate to code it as such. Coding to lobular would also be ok, though that would lose the special feature of the signet ring cells. I would rather not code to 8524, since it is not really a mix of lobular and something else."
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 | |
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20031210 | Other Cancer-Directed Therapy--Hematopoietic, NOS: Is there a hierarchy for selecting which code to use when a patient receives more than one type of "other treatment"? See Description. | Patient was diagnosed with Myelodysplastic Syndrome, probably refractory cytopenia with multilineage dysplasia. Good candidate for investigational studies for transfusion-dependent patients. Patient was enrolled in a high dose vitamin D study. Patient also received transfusions. | SEER has not established a hierarchy of the codes listed under Other Treatment. If the patient receives more than one type of other treatment as the first course of treatment, assign the code that provides the most information about how the patient was treated and use the remarks fields to explain. Code Other Treatment for the case example above as 2 [Other experimental therapy]. Use the remarks fields to describe the transfusions and vitamin D therapy. |
2003 |
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20031087 | EOD-Extension--Lymphoma/Brain and CNS: How is this field coded for a primary brain lymphoma that is described as multi-focal? | For cases diagnosed 1998-2003: Since brain is the only site involved in this example, assign code 11 [Localized involvement of a single extralymphatic organ or site]. | 2003 | |
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20031202 | Surgery of Primary Site--Head & Neck: How is this field coded for a surgery titled "Parotidectomy with facial nerve dissection"? See Description. | If the operative report is not titled "total parotidectomy," can we assume that less than total parotidectomy was done? Can we assume that "facial nerve dissection" and "facial nerve monitoring" are other ways of stating "facial nerve spared"? | Use the best information available to determine whether or not all of the parotid has been removed. It is important to read the entire operative report and review the content of the pathology report. The Op report will usually include wording about how much was removed, and this can be confirmed by the path report. Do not make assumptions about the extent of the surgery based solely on the title used on the operative report.
For cases diagnosed 1998-2003: Code 30 [less than total parotidectomy] can be used when the parotid is not totally removed, but the exact type of partial parotidectomy cannot be determined. "Facial nerve monitoring" and "Facial nerve dissection" are synonymous with "facial nerve sparing." |
2003 |