Report | Question ID | Question | Discussion | Answer | Year |
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20021140 | EOD-Extension--Head & Neck: How do you code extension for a supraglottic larynx primary with "pre-epigolottic space" invasion? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 65 [Pre-epiglottic tissues]. Extension to "pre-epiglottic space" is equivalent to extension to "pre-epiglottic tissue." |
2002 | |
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20021031 | Primary Site--Meninges: Should the primary site for a meningioma of the right frontal lobe be coded to C71.1 or C70.0? See discussion. | In the opinion of some neurologists it is more important to capture the lobe in which the meningioma is located rather than code the primary site to meninges. Should a meningioma always be coded to meninges for primary site? | Code the Primary Site field to C70.0 [cerebral meninges], the suggested site code for most meningiomas. Meningiomas arise from the meninges, not the brain (although they can invade brain). ICD-O-3 does not differentiate the specific location of the brain that the meninges cover. The information of interest to neurologists would have to be captured in an optional or user-defined field. | 2002 |
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20021146 | Primary Site--Lymphoma: Is the primary site likely to be extranodal for a lymphoma that presents in an extranodal site and lymph nodes which are regional for that site? Is the primary site also likely to be extranodal if an extranodal site and lymph nodes are excised? See discussion. | Example: Work-up included a negative CXR. A CT showed multiple dilated loops of small bowel consistent with obstruction and nodular prominence at the base of bladder. Laparotomy with resection of small bowel and multiple biopsies of enlarged mesentric lymph nodes performed. Final path diagnosis: Lymphoma in a "mesenteric mass" and in "small bowel." There was no mention of lymph nodes in the final diagnosis and the detailed micro described the mesenteric mass as just adipose tissue replaced by lymphoma. However, the gross for that specimen states 4 lymph nodes were found in the fat. The small bowel micro described an ulcerated lesion of the small bowel extending into muscularis. | For cases diagnosed prior to 1/1/2010:Code the Primary Site field to C17.9 [small bowel] for the example. When an extranodal organ and that organ's regional nodes are involved, the extranodal site is most likely the primary, unless there is extension from the regional nodes to the organ. If the primary site cannot be determined for a lymphoma diagnosed in both a nodal and extranodal site, code to C77.9 [lymph nodes 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. |
2002 |
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20021063 | EOD-Pathologic Review of Number of Regional Lymph Nodes Examined: What code is used to represent this field when a path report from a lymph node biopsy or dissection describes lymph node "portions" or "fragments"? See discussion. | 1) Lymph nodes, right pelvic dissection: No evidence of malignancy in 4 portions of lymph node examined. (Should we code the number examined as 01, 04, or 97?) 2) Lymph nodes, left pelvic dissection: 5 fragments of lymph nodes show no evidence of malignancy. (Should we code the number examined as 05 or 97?) 3) Biopsy of right neck mass: Malignancy in fragments of lymph nodes. The following month, pt had a right modified lymph node dissection: 16/32 lymph nodes are positive for malignancy. (Should we code the number examined as 32, 33, 97, 98?) |
For cases diagnosed 1998-2003:
The total number of lymph nodes examined is recorded in EOD-Num of Reg LN Examined. If the number of actual lymph nodes represented by the "fragments" or "portions" cannot be determined, assign code 96, 97, or 98 as appropriate. 1) Based on the terminology "four portions of lymph node (singular)" code to 01 despite "dissection" terminology. 2) Code to 97 based on "fragments of lymph nodes (pleural)" terminology and procedure identified as dissection. 3) Code to 97 based on statement of "fragments of lymph nodes (pleural)" for biopsy plus dissection. |
2002 |
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20020024 | Reportability--Cervix: The SEER Program Code Manual lists CIN III and carcinoma in situ of the cervix as not being reportable for cases diagnosed in 1996 or later, but does not list "adenocarcinoma in situ" or "squamous cell carcinoma in situ." Are these histologies still reportable? | For primary site cervix uteri, only histologies with behavior codes of 3 [invasive] are reportable to SEER for all registries.
Some SEER registries have opted to continue to collect behavior codes of 2 [in situ] for cervix uteri primaries. |
2002 | |
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20021091 | Reportability--Hematopoietic, NOS: Are the terms "thrombocytosis, NOS" and "thrombocythemia, NOS" non-reportable to SEER? See discussion. |
Our understanding from SEER about how to classify these types of clinical impressions for the 2001 and later reportable blood diseases is as follows: If we cannot prove that it is malignant, then we should be conservative and exclude the case for reporting to SEER. |
For cases diagnosed prior to 1/1/2010:The terms "thrombocytosis, NOS" and "thrombocythemia, NOS" are not reportable to SEER. 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. |
2002 |
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20021136 | Date of Diagnosis/Histology (Pre-2007): How should we code these fields for "atypical fibroxanthoma" of the left cheek diagnosed in October 1999 that is followed by a June 2000 punch biopsy with a microscopic description in the pathology report of "superficial form of malignant fibrous histiocytoma"? See discussion. | Should the diagnosis date for the malignant fibrous histiocytoma be October 1999 because it is called "residual/recurrent atypical fibroxanthoma" in the June 2000 final diagnosis of pathology report? In the microscopic description it is called a "malignant fibrous histiocytoma." Per an August 2000 outpatient note, "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." | For tumors diagnosed prior to 2007:
Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.
If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.
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. |
2002 |
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20021103 | Surgery of Primary Site/First Course Treatment--Liver: If disease progression is so rapid that the initial therapy plan is changed before patient receives any therapy, would "no therapy" be the first course? See discussion. | Patient was diagnosed with liver cancer on 8/23 and on 9/6 a hepatectomy was recommended. However, patient was hospitalized on 9/19 with ascites. Patient underwent embolization instead of a hepatectomy during that admission. | Code the "embolization" (or hepatic artery embolization, HAE) in Surgery of Primary Site. Assign code 10 [local tumor destruction, NOS]. The embolization is coded as first course of therapy for this case because it seems that this patient was not adequately staged until 9/19 -- there is no indication on this case of the stage of disease in August or early September. Furthermore, no treatment was started before the embolization. Therefore, the ascites is not "progression of disease" in this case -- it is taken into account as part of the initial stage of disease. This procedure was previously coded as other therapy, experimental. Code as surgery as of July 2005. |
2002 |
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20021034 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma in a tubulovillous adenoma with a mucinous component, the mucinous component is less than 50%"? See discussion. | For mucinous only, the tumor must contain at least 50% mucinous to be coded to the specific histology. | For tumors diagnosed prior to 2007:
Code the Histology field to 8263/3 [adenocarcinoma in a tubulovillous adenoma]. Because the mucinous component involves less than 50% of the tumor, the histology is not coded to mucinous. For mucinous only, the tumor must be at least 50% mucinous, mucin producing, to be coded to the specific histology.
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. |
2002 |
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20021074 | Tumor Markers--Breast: If the ERA/PRA results reported differ for separate breast specimens removed for a single primary, do we code the results as positive or negative? | For cases diagnosed 1998-2003:
Code both the Tumor Marker 1 and Tumor Marker 2 fields to 1 [positive] when a single primary breast tumor has both positive and negative ERA/PRA receptors. |
2002 |