Report | Question ID | Question | Discussion | Answer | Year |
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20031030 | Primary Site--Head & Neck: What is the primary site for a tumor location described as being in the "gingiva between teeth #s 18 and 19? | Code the primary site as C03.1, lower gum. According to the system used by the American Dental Association, tooth #18 and tooth #19 are lower. Teeth #1-16 are upper. Teeth #17-32 are lower. |
2003 | |
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20031189 | Multiple Primaries (Pre-2007)--Thyroid: Would a papillary carcinoma of the right lobe of the thyroid diagnosed approximately 2 1/2 years after a papillary carcinoma of the left lobe be coded as a second primary? See Description. | 8/31/1999: papillary carcinoma, left lobe thyroid, treated with lobectomy. 1/17/2002: papillary carcinoma, right lobe, treated with lobectomy, completion thyroidectomy. |
For tumors diagnosed prior to 2007:
Yes, this is a second primary. The second papillary carcinoma was more than 2 months after the first and not specified as recurrent or metastatic.
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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20031023 | Grade, Differentiation: Can differentiation be coded from the pathology report for a biopsy from tissue involved by local recurrence? | Code grade from original primary site. Do not code grade from a local recurrence. | 2003 | |
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20031086 | EOD-Clinical Extension--Prostate: Must all three criteria be met (an elevated PSA; documentation that the physical exam was negative; and, if a TRUS was done, there is documentation that the findings were negative) in order to code this field to 15 [Tumor identified by needle by elevated PSA]? | For cases diagnosed 1998-2003:
Refer to the Prostate EOD Coding Guidelines, Final version distributed to SEER Registries 6/20/2001.
Prostate clinical EOD extension code 15 is used when all three criteria are met as listed on page 3 of the Prostate EOD Coding Guidelines. Meeting 1 or 2 of the 3 criteria is not sufficient for code 15. PE must be done and documented as negative. TRUS may or may not be done, but if done, must be documented as negative. PSA must either be elevated or there is no documentation about the PSA.
Codes 20 and 23-24 would be used with positive physical exam or positive TRUS.
Use codes 30-34 when there is no documentation that the physical exam was negative, or no documentation that the TRUS was negative, or when the prostatic apex is involved. |
2003 | |
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20031024 | Surgical Fields--Head & Neck: How does one code the removal of benign submandibular and sublingual glands performed during a neck dissection for a head and neck cancer? See discussion. | Should the removal be coded as incidental in the surgical Procedure if the Other Site field? Does it make a difference if the submandibular gland is removed en toto with lymph nodes or if the gland is submitted as a separate specimen? Does it make a difference if the glands are involved? | Removal of the lower salivary glands is part of a radical neck dissection and is not recorded in Surgery of Primary Site or Surgery of Other Site. Radical neck dissection is coded under "Scope of Regional Lymph Node Surgery." It does not matter whether or not the gland is submitted as a separate specimen. It does not matter whether or not the gland is involved. |
2003 |
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20031188 | EOD-Size of Primary Tumor--Breast: How would this field be coded, using the revised and expanded breast code, for a lesion described as "1.3 cm infiltrating ductal carcinoma, associated DCIS?" | For cases diagnosed 1998-2003: Code size of primary tumor as 013. The phrasing suggests that the infiltrating ductal carcinoma measures 1.3 cm. DCIS is also present, but no size mentioned. | 2003 | |
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20031060 | Histology--Hematopoietic, NOS: Because histology 9895/3 [Acute myeloid leukemia with multilineage dysplasia] was recognized as a distinct entity by WHO with too few cases of the subtypes [with or without prior MDS] to warrant separate histology codes for each, should the wording for the non-bold definitions in ICD-O-3 be changed to the following in both the alpha and numeric sections? See Description.
AML with multilineage dysplasia and prior MDS AML with multilineage dysplasia and without prior MDS |
How do we code histology for the following case of AML? Patient was admitted for profound anemia and thrombocytopenia with no immediate explanation. Path final diagnosis on bone marrow biopsy: acute myelogenous leukemia (AML). Per micro description: findings are characteristic of AML that appears to be arising within the context of a myelodysplastic syndrome. The discharge diagnosis (2 days after bone marrow biopsy) read: myelodysplastic syndrome with profound anemia and thrombocytopenia. Do we code the histology per the final path diagnosis (code 9861/3)? Using the current version of ICD-O-3, we could arrive at a histology code of 9895/3 based on the micro findings of AML with prior myelodysplastic syndrome. However, per the above-mentioned SEER e-mail, we would not because there was no mention of multilineage dysplasia. |
For cases diagnosed prior to 1/1/2010:To assign code 9895, it is important that the diagnosis includes "multilineage dysplasia." Use code 9895 when the diagnosis is with or without prior (not concurrent) myelodysplastic syndrome AND multilineage dysplasia. Acute myeloid leukemia without prior myelodysplastic syndrome and without multilineage dysplasia is coded 9861 [Acute myeloid leukemia, NOS]. Although the wording of 9895 cannot be changed, coders can make a note that the synonyms are intended to include: -Acute myeloid leukemia WITH multilineage dysplasia with prior myelodysplastic syndrome and -Acute myeloid leukemia WITH multilineage dysplasia without prior myelodysplastic syndrome. The histology code for the case example is 9861/3 [Acute myeloid leukemia, NOS]. 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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20031002 | Histology (Pre-2007)--Cervix: Is 8384/3 [adenocarcinoma, endocervical type] a specific histology type that must be stated or does it apply to any adenocarcinoma arising in the endocervical? Should the ICD-O-3 histology code of 8384/3 [Adenocarcinoma, endocervical type] be used for final diagnoses of "adenocarcinoma of the endocervix" or "adenocarcinoma of the cervix"? | For tumors diagnosed prior to 2007:
Histology code 8384 is for adenocarcinoma of endocervical type. This specific type (endocervical) must be part of the diagnosis in order to assign code 8384. This histology code is not to be used for Adenocarcinoma, NOS of the endocervix or cervix. Adenocarcinoma of endocervical type can be diagnosed in other tissues and if so it will be stated as endocervical type. Adenoca of the endocervix would be coded to plain Adenoca.
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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20031119 | EOD-Extension/EOD-Lymph Nodes--Colon: For this primary, under which field are satellite tumor nodules in mesenteric adipose tissue coded? See Description. | Sigmoid colon, low anterior resection: Invasive adenocarcinoma, 5.5 cm greastest dimension, moderately differentiated. Tumor invades through muscularis propria, into mesenteric adipose tissue. No penetration of visceral peritoneum. Proximal, distal, and radial margins free of tumor. Satellite tumor nodule present within mesenteric adipose tissue, 1.5 cm diameter, located 2.8 cm from main bowel wall tumor. Ten lymph nodes identified, with no evidence of metastatic tumor.
Comment: The satellite tumor nodule present within the mesenteric adipose tissue has an infiltrating, irregular contoured appearance and does not appear to represent a previously replaced lymph node. This appears to be a local metastasis with histologic features most commonly associated with venous invasion (see AJCC Cancer Staging Handbook, Sixth Edition, 2002, page 131 for current staging terminology). |
For cases diagnosed 1998-2003: For EOD, each grossly detectable nodule in the regional mesenteric fat is counted as one regional lymph node. | 2003 |
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20031084 | Histology (Pre-2007)--Colon: What code is used to represent the histology "Adenocarcinoma, intestinal type?" See Description. | The code 8144/3 is not valid for colon primaries. Should we code these as 8140/3 [Adenocarcinoma, NOS] or over-ride the error message? | For tumors diagnosed prior to 2007:
Code adenocarcinoma, intestinal type of the colon 8140 [Adenocarcinoma, NOS]. Do not use code 8144 for intestinal type adenocarcinoma in the colon.
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 |