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Report Produced: 02/24/2026 21:32 PM

Report Question ID Question Discussion Answer Year
20021187

Reportability: When a hospital pathologist sends the slides from an original biopsy to two or more outside reviewers and the reviewers differ on whether or not the case is reportable, is the case SEER reportable? Does the decision to treat the patient have any bearing on whether the case would be reportable?

Typically, the final diagnosis of the reviewing pathologist is the one used to determine whether the case is SEER reportable. If two or more reviewing pathologists disagree as to whether the case should be reportable, determine reportability based on the following priority order:

1) If the patient is treated for cancer, the case is reportable.

2) If the patient is not treated for cancer, use the amended diagnosis on the original pathology report if the hospital pathologist used the reviewing pathologists' opinions in establishing his new diagnosis.

3) If there is not an amended diagnosis for the original hospital pathology report, use the clinician's opinion regarding what the diagnosis is to determine whether the case is reportable.

 2002
20021172 EOD-Extension--Head & Neck: How much information is needed for a head and neck primary in order to code extension to localized versus unknown? What code is used to represent this field when the only information for a buccal cavity primary is a positive aspiration of the buccal mass?

For cases diagnosed 1998-2003:

Code the EOD-Extension to 99 [Unknown] for this case until more information is received. The available information does not describe the primary site and there is a complete lack of staging information.

Head and neck cancers spread early and often to nodes. Do not code the EOD-Extension to localized when the information is as limited as it is for this example.

 2002
20021132

EOD-Extension: The medical record lacks a clear statement that metastatic workup was complete. A metastatic deposit is identified within 4 months of diagnosis and while the patient is undergoing first course of treatment. How do you code the EOD-Extension field?

For cases diagnosed 1998-2003:

In coding the EOD-Extension field, ignore metastasis that is discovered after the initial workup is completed regardless of the timeframe from diagnosis date until the date the metastatic deposit was discovered. The metastasis is progression of disease.

Any of the following represents progression of disease. Do not code the subsequently identified metastatic involvement in the EOD:

1) The metastatic workup was complete and treatment started before the procedure was done that found the metastatic involvement.

2) A procedure, such as a scan, was negative initially and a repeat of that procedure is now positive.

3) The treatment plan is developed for a localized disease process.

If you are unable to determine whether the newly discovered metastasis represents progression or is part of the initial workup, regard the metastasis as progression. Do not code the metastasis in the EOD-Extension field.

 2002
20020052 EOD-Extension--Lung: How do you code extension for a lung tumor described on bronchoscopy as "obstructing the RUL and intruding into the right bronchus intermedius. Small tumor nodules distally in midline of anterior trachea wall"?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 85 [Metastasis] because the tumor nodules are discontinuous from the primary tumor.

 2002
20021042

Hormone Therapy--Breast: Should Zoladex (gosrelin) or Lupron (leuprolide acetate) be coded as treatment for breast cancer when the physician does not indicate whether or not these drugs are intended as cancer-directed therapy? See discussion.

According to an oncologist at the research hospital in our region, these drugs are given in combination with chemotherapy for two reasons:

1) To preserve ovarian function.

2) The agents may be more effective in treating breast cancer when given in conjunction with chemotherapy than with chemotherapy alone.

For cases diagnosed 1/1/2003 to 12/31/2010: Code Zoladex (gosrelin) and Lupron (leuprolide acetate) as 01 [Hormone therapy administered as first course therapy] only when stated to be given as part of the first course of cancer-directed therapy. If you do not know whether these drugs were given to preserve ovarian function or as an adjunct to chemotherapy (i.e, there is no treatment plan), do not code as Hormonal treatment given.

2002
20021106 Histology (Pre-2007)/Diagnostic Confirmation: What code is used to represent the histology that initially presents on uterine curettage as a hydatidiform mole and after pulmonary metastases develop a month later, the clinical diagnosis is "metastatic gestational trophoblastic disease"?

For tumors diagnosed prior to 2007:

Code the Histology field to 9100/3 [Choriocarcinoma]. Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma.

Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only] based on the information above. However, if imaging, direct visualization, or another method identified the pulmonary metastases, then code the Diagnostic Confirmation accordingly.

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
20020044

Terminology/EOD-Extension--Prostate: How does SEER define the prostatic "apex"? See discussion.

Some pathologists define the prostatic apex as including the bottom third of the prostate whereas others regard only the bottom-most portion of the gland to be the apex.

SEER defines the apex as being the bottom-most portion of the gland. Apex means "narrowest part," which in the prostate would be the bottom-most portion of the gland.

 2002
20021181 Radiation/Chemotherapy: How do we code radiation and chemotherapy when the only statement we have is that the patient is "referred to either an oncologist or a radiation therapist"? For cases diagnosed 1/1/2003 and after: A referral does not mean that the radiation therapy or chemotherapy was actually recommended. These cases need follow-back to see if treatment was recommended and/or administered. Some registries code these cases as 8 [Radiation recommended, unknown if administered] or 88 [Chemotherapy recommended, unknown if it was administered] and routinely review all cases with 8 or 88 codes. Upon review, the codes are updated depending on the information found. If there is no information available, the code 8 or 88 is changed to 0 or 00 [None]. 2002
20020018 EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Cervix: What codes are used to represent these fields for a cervix primary when the only information on lymph nodes is a CT of the pelvis showing "pelvic adenopathy" (no surgery was done)? Code the EOD-Lymph Nodes field to 9 [unknown]. Code the Pathologic Review of Number of Regional Lymph Nodes Positive field to 98 [No nodes examined] and the Lymph Nodes Examined to 00 [No nodes examined] because there was no resection of the primary organs. Adenopathy, NOS, per SEER guidelines, is not coded as lymph node involvement 2002
20021176 Histology (Pre-2007)/Multiple Primaries (Pre-2007)--Breast: What code is used to represent histology for a case with a biopsy specimen that reveals "infiltrating ductal carcinoma with ductal carcinoma in situ, comedo subtype, non-extensive" in one quadrant of the breast and a mastectomy specimen with "invasive pleomorphic lobular carcinoma with lobular carcinoma in situ" in another quadrant of the breast? Paget disease is identified in the nipple section.

For tumors diagnosed prior to 2007:

Code the Histology field to 8522/3 [infiltrating duct and lobular carcinoma]. We are choosing the ductal and lobular combination over the Paget disease and lobular combination because it is more important for analysis purposes.

Be careful in using combination codes to code separate tumors in different locations of the same breast as a single primary. Currently there are only three combination codes for the breast that allow for this situation, 8522 [duct and lobular], 8541 [Paget disease and infiltrating duct] and 8543 [Paget disease and intraductal]. Other histologic type differences that occur as separate tumors in different parts of the same breast are coded as multiple 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.

 2002