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.
Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are represented when a1998 invasive squamous cell carcinoma of the true vocal cord is followed by a 1999 diagnosis of in situ squamous cell carcinoma of the true vocal cord (called "recurrent" by the clinician), and in 2001 there is another invasive squamous cell carcinoma of the true vocal cord (no statement of recurrence)? Would your answer be any different if no statement of "recurrent" had been made in 1999?
For tumors diagnosed prior to 2007:
Code this case as two primaries, an invasive true vocal cord primary in 1998 and another invasive true vocal cord primary in 2001.
If there had been no statement of recurrence for the 1999 in situ diagnosis and the 1999 diagnosis was more than two months following the 1998 diagnosis, this case would be coded as three primaries.
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.
Other Therapy: What code is used to represent treatment with "Epithilone" or "Epothilone"?
Code the Other Cancer-Directed Therapy field to 2 [Other experimental cancer-directed therapy (not included elsewhere)], until the exact mechanism of action is determined for this drug. This drug is in phase I clinical trials. It has a similar action to Taxol, but is derived from a different source.
Grade, Differentiation--Bladder: What codes are used to represent this field for the four bladder cases described in the discussion section that have a combination of grades mentioned in the pathology reports? See discussion.
1) Final path diagnosis: papillary transitional cell carcinoma, high grade. Micro description states: High grade, poorly differentiated carcinoma.
2) Well to moderately differentiated papillary transitional cell carcinoma, grade 1-2/3.
3) Urothelial carcinoma, high grade (poorly differentiated, grade 3 of 3).
4) High grade papillary urothelial carcinoma (papillary transitional cell carcinoma, grade 3 out of 4).
For cases diagnosed January 2004 and forward:
1) Grade 4. High grade is coded 4. Code the grade stated in the final diagnosis.
2) Grade 3. Grade 1-2/3 is coded 3. Use the three-grade conversion table in the 2004 SEER manual.
3) Grade 4. Grade 3 of 3 is coded 4. Use the three-grade conversion table in the 2004 SEER manual.
4) Grade 3. "Grade 3 out of 4" is coded 3 and is more precise than "high grade."
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."
Other Cancer Directed Therapy--Hematopoietic, NOS: Is "aspirin" treatment for primary polycythemia? See discussion.
Aspirin is listed as treatment for "thrombocythemia" in the Abstracting and Coding Guide for the Hematopoietic Diseases but not for "primary polycythemia."
Do not code aspirin as treatment for primary polycythemia (polycythemia vera).
Histology (Pre-2007)/Primary Site/EOD-Extension--All Sites: How do you code these fields for a resected thyroid that is negative for any diagnostic abnormality and a left ovary that demonstrates "papillary thyroid carcinoma arising in a cystic teratoma"? See discussion.
Teratomas occurring in the ovaries frequently contain various types of fully differentiated tissue that normally occur in other body parts. Should the primary be coded to the ovary or to the organ in which that type of tissue normally occurs?
For tumors diagnosed prior to 2007:
Code the Primary Site field to the organ in which the cancer arose. For this tumor, code the Primary Site field to C56.9 [ovary] and Histology to 8260/3 [papillary carcinoma of thyroid]. Use the ovary EOD for tumors diagnosed 1998-2003.
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.
Histology (Pre-2007): What code is used to represent the histology "non oat cell carcinoma"?
For tumors diagnosed 2001-2006:
Code the Histology field to 8046/3 [non-small cell carcinoma] if the pathologist does not provide a more specific histologic type. "Non oat cell" is a synonym for "non-small cell."
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.
Reportability/Behavior Code--Bone Marrow: Is T-cell large granular lymphocytic leukemia SEER reportable? Pages 102, 147, 156, 160-162 and 167 of the ICD-O-3 list it as 9831/1, but on page 17 this is listed as 9831/3.
For cases diagnosed prior to 1/1/2010:T-cell large granular lymphocytic leukemia [9831] is a very indolent form of leukemia. It was assigned a behavior code of 1 by the editors of ICD-O-3 (as noted on pages 102, 147, 156 160-162, and 167 of the ICD-O-3 manual). The table on page 17 is the World Health Organization list of hematopoietic and lymphoid tumors. WHO recognizes TCLGLL as a malignancy. The disease is infrequently symptomatic enough to be diagnosed. However, when any of the terms listed with code 9831 are described as malignant or aggressive, report to SEER as a malignancy with a behavior code of /3.
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.
EOD-Extension/EOD-Lymph Nodes--Rectosigmoid: How do you code these fields for a scan-based clinically staged T3 N1 rectosigmoid primary in a patient who received chemotherapy and radiation prior to a resection that demonstrated invasion only into the muscularis and no positive lymph nodes?
For cases diagnosed 1998-2003:
Use the best information available, in this case, the clinical staging, to code EOD. Code the EOD-Extension field to 40 [Invasion through muscularis propria or muscularis, NOS] and the EOD Lymph Node field to 3 [Regional lymph node(s) NOS] because the case had a clinical stage of T3 N1. EOD is coded using the most extensive clinical or pathologic stage.
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