Report | Question ID | Question | Discussion | Answer | Year |
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20021126 | EOD-Extension--Head & Neck (Tonsil): How should the EOD-Extension field be coded for bilateral tonsil involvement? See discussion. | Tonsillectomy and bilateral radical neck dissections were done. The path diagnosis was left and right tonsils: squamous cell carcinoma, bilateral tonsils with negative inked surgical margins of resection. Physical exam and operative findings did not mention any extension beyond the tonsils. We originally coded the EOD-Extension field to 30 for a bilateral tonsil primary. The case failed the SEER Edit IF41 (Primary Site/Lat/EOD). According to that edit, if laterality is 4 then the EOD-Extension field must not be 00 through 30. We recoded the EOD-Extension field to 99 in order to comply with the SEER edit. |
For cases diagnosed 1998-2003:
Code EOD extension as 30 [Localized, NOS] and laterality as 4 [Bilateral involvement]. The next update to the SEER edits will allow this combination. |
2002 |
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20021016 | Histology (Pre-2007)/Behavior Code: What code is used to represent the histology "foci of well differentiated intramucosal carcinoma [carcinoma in situ] arising on the surface of a tubular adenoma"? The pathologist referred to this colon biopsy as "in situ". | For tumors diagnosed prior to 2007:
Assign histology code 8210 [adenocarcinoma in a tubular adenoma] and behavior code 2 [in situ]. "In situ" is specified by the pathologist.
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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20021021 | Reportability--Hematopoietic, NOS: Should we add the missing terms listed in the Abstracting and Coding Guide for the Hematopoietic Diseases to ICD-O-3 because these absent synonyms would not be identified during hematology casefinding? See discussion. | The Abstracting and Coding Guide for the Hematopoietic Diseases gives a preferred term for each code followed by a list of synonyms, not all of which are listed in the ICD-O-3. Two examples are: 1) 9962/3 [Essential Thrombocythemia] has 6 synonymous terms listed, but the last three of them are not in ICD-O-3. 2) 9930/3 [Myeloid Sarcoma] has the synonym "extramedullary myeloid tumor" which is not in ICD-O-3. | For cases diagnosed prior to 1/1/2010:Do not add these synonyms to ICD-O-3. The Abstracting and Coding Guide for the Hematopoietic Diseases lists synonyms for the preferred terms to assist in the classification of these other terms. In the absence of a specific code for the synonym, code to the preferred term. For casefinding, these terms would be grouped in a broader category of hematologic diseases under an ICD-9-CM or ICD-10 code and, therefore, will be identified during casefinding procedures using the disease index. 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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20021205 | EOD-Extension--Melanoma: Is "erosion" synonymous with "ulceration" for melanoma cases? | For cases diagnosed 1998-2003:
No, do not interpret the term "erosion" as a synonym for "ulceration" when coding the EOD-Extension field for melanoma. According to AJCC's melanoma curator, erosion is not necessarily the same as ulceration. |
2002 | |
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20021119 | Radiation--Choroid: How do you code treatment involving a "radioactive iodine plaque" for choroidal melanomas? | Code the Radiation field to 2 [Radioactive implants]. Codes for radiation are based on HOW the radiation is delivered, rather than the particular type of radioactive material used. Radioactive eye-plaques contain rice-sized iodine-125 or palladium-103 seeds which emit low energy photons. They are sewn or glued into the eye. The plaque remains for 5 to 7 days and is then removed. |
2002 | |
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20021003 | Multiple Primaries (Pre-2007): Whenever two hollow organs are diagnosed simultaneously with the same histology, one being invasive and the other in situ, can one assume that mucosal spread has occurred and that this situation represents one primary? In the absence of a physician statement, how do you determine mucosal spread from one organ to another? | For tumors diagnosed prior to 2007:
Yes, this type of situation represents one primary. A tumor that is breaking down can be invasive in the center with in situ cancer at the margins. Occasionally the in situ margin can move into a contiguous organ with the same type of epithelium.
Physicians may describe mucosal spread in various manners. You will see the terms "intramucosal extension," "in situ component extending to," or statements of an invasive component in one organ, with adjacent/associated in situ carcinoma in a contiguous organ with the same type of epithelium. A frequent example of this process is bladder cancer extending into the prostatic urethra via mucosal spread.
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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20021044 | Histology (Pre-2007)/Grade, Differentiation: Can histology and/or grade be coded from a metastatic site? See discussion. | Example 1: No pathology specimen is available from the primary site for a lung primary. Rib biopsy demonstrated "anaplastic adenocarcinoma."
Example 2: Lung tissue biopsy revealed "poorly differentiated non-small cell carcinoma" for a lung primary. Pleural effusion cytology was consistent with "adenocarcinoma". |
For tumors diagnosed prior to 2007:
Example 1: Code the Histology and Grade, Differentiation fields to 8140/39 [adenocarcinoma, NOS, grade not stated]. Because there was no microscopic examination of tissue from the primary site, the histology may be coded from the microscopic examination of the tissue from a metastatic site. Do not code grade from a metastatic site regardless of whether the involvement of the metastatic site is by direct extension or by discontinuous metastases.
Example 2: Code the Histology and Grade, Differentiation fields to 8046/33 [non-small cell carcinoma, poorly differentiated]. Because there is a microscopic examination of tissue from the primary site, that information should be used to code histology rather than a cytology of a metastatic site.
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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20021149 | EOD-Extension--Head & Neck: In the absence of a clear surgical or pathologic description of how the salivary gland involvement relates to the head and neck primary, do we code the involvement as direct extension, further extension or metastasis? See discussion. | A composite resection of tonsillar mass and a modified radical neck dissection is performed. According to the pathology report: Squamous cell carcinoma involvement of tonsil with invasion of skeletal muscle. A separate specimen labeled "tumor" indicates a salivary gland is also involved with tumor. Neck dissection: 1 lymph node with metastasis. | For cases diagnosed 1998-2003:
In the absence of a clear statement that the gland was involved by direct extension, code the EOD-Extension field to 85 [Metastasis]. In this case, the salivary gland tumor was described as a "separate specimen" that contained the salivary gland. The extension does not appear to be contiguous for this case.
If the salivary gland involvement had been by direct extension, which would be assumed if there had been contiguous involvement of the gland with the primary site, then code the EOD-Extension field to 80 [Further extension]. If there had been direct extension, the surgeon probably would not have dissected through the tumor. The resection specimens would have been contiguous. |
2002 |
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20021053 | EOD-Extension--Pancreas: How would you code extension for the following non-surgically treated pancreas primaries? None of these cases has TNM staging to assist with classifying the extent of disease. See discussion. | 1) CT scan: Cystic lesion in body of pancreas. Discharge dx: pancreas ca. 2) Discharge dx: CBD obstruction due to probable early ca in head of pancreas. 3) CT scan: mass involves the head and body of the pancreas. No evidence of abdominal mets. Discharge dx: Locally advanced pancreatic ca. 4) H&P: Pt with splenomegaly probably secondary to splenic vein thrombosis and a large ca of the tail of pancreas. Imp: Advanced pancreatic ca of the tail of pancreas. Would you code extension to splenic vein [56]? 5) H&P: Pancreatic ca with extension or mets into porta hepatis. (Would you assume direct extension or mets?) 6) CT scan: Pancreas ca. Significant peritoneal implants. (Would you assume the implants to be related to the pancreas primary and code as involvement?) |
For cases diagnosed 1998-2003:
The information provided for these pancreatic primary examples is very limited. Additional information should be sought. If not available, code the EOD-Extension field to: 1) 10 2) 10 3) 10 4) 99 5) Assuming primary in head, body or tail of pancreas, 76 6) 85 |
2002 |