| Report | Question ID | Question | Discussion | Answer | Year |
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20020002 | Date Therapy Initiated: What date should be entered in Date Therapy Initiated when treatment follows a surgical procedure that is not coded under Surgery of Primary Site? See discussion. | If a patient has a surgical procedure that is not coded in the Surgery of Primary Site field and then the patient undergoes additional first course of treatment, such as radiation therapy, how should the Date Therapy Initiated field be coded? | In this example, code the Date Therapy Initiated field to the date of the first surgical procedure. If a SEER edit is triggered, please notify us. | 2002 |
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20020015 | Histology (Pre-2001): For cases diagnosed before 1/1/01, what code is used to represent the histology "small cell neuroendocrine carcinoma"? | For tumors diagnosed prior to 2001, code the Histology field to 8041/3 [small cell carcinoma] for "small cell neuroendocrine carcinoma". | 2002 | |
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20021087 | 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. |
2002 | |
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20021012 | EOD-Extension--Lymphoma: How do you code stage and EOD for an extranodal lymphoma with bilateral involvement of a paired site? See discussion. |
For example, we frequently see cases of lymphoma occurring in bilateral orbits, or both lungs. This issue was discussed at a 1991 SEER meeting with the tentative answer being that lymphoma involving both organs of a paired site will be coded as stage I (e.g., both eyes or both lungs), as this would be contiguous disease. However, an extranodal lymphoma involving tissue of both limbs (e.g., soft tissue of both arms) will be coded as stage IV because this represents wide areas of involvement that have no connection. | For cases diagnosed 1998-2003:
Bilateral involvement of an extralymphatic paired organ is coded as involvement of a single extralymphatic organ or site for lymphomas. The EOD extension code would be at least 11 (Stage IE). Staging lymphomas of any site depends on whether one or more lymph node regions and/or extralymphatic organs are involved, and whether sites on one or both sides of the diaphragm are involved. |
2002 |
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20021007 | Scope of Regional Lymph Node Surgery: If a named regional lymph node is aspirated should this field be coded to 1 [Regional lymph node removed, NOS], as is stated on page 127 of the SEER Program Code Manual, or should this field be coded to a more specific code when that is available (e.g. Lung primary code 3 [Ipsilateral mediastinal and/or subcarinal nodes])? | For cases diagnosed 1/1/2003 and after: A generic scheme was created for the Scope of Regional Lymph Node Surgery field. As a result, there no longer are codes available that represent specific named lymph node chains. Code aspiration of a lymph node to 1 [Biopsy or aspiration of regional lymph node, NOS]. | 2002 | |
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20021030 | Grade, Differentiation--All Sites: Why was the decision made not to code all "3-component differentiation systems" the same way that Bloom-Richardson is coded? For example, SEER codes a low grade BR to 1 for the Differentiation field and a low grade for other grading systems to 2. See discussion. | Our Pathologist Consultant agrees with SEER's guideline to code the Bloom-Richardson and B&R modifications of low, intermediate and high to 1, 2 and 3 respectively and thinks all 3-component systems should be coded that same way because it better represents the differentiation of the tumor. In his opinion, coding all other 3-component systems to a differentiation of 2, 3 and 4 respectively, is overstating the degree of differentiation. | The rules for coding histology are approved and used by all of the major standard setters through agreements reached in the NAACCR Uniform Data Standards Committee. This issue is under review by our medical advisors and a special committee. Changes will be taken to the Uniform Data Standards Committee for review and approval. | 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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20021005 | EOD-Extension--Lymphoma: What code is used to represent this field for an extranodal lymphoma that has more than one tumor in the primary site OR has intraluminal extension from the primary site to an adjacent organ? See discussion. | 1. Small lymphocytic lymphoma with 2 tumors in the stomach. 2. Lymphoma involving the cecum and ileum. 3. Lymphoma of the fundus of stomach with extension into the esophagus. |
For cases diagnosed 1998-2003:
Using the EOD scheme for lymphoma, code the Extension field to 11 [Localized involvement of a single extralymphatic organ or site; Stage IE] for all 3 of these cases.
For the stomach lymphoma: There are 2 areas of lymphoma, but it is still confined to one site.
For the other 2 lymphomas: Intraluminal (mucosal) spread of the lymphoma never equals extension. The same phrase that was added to code 21, "Direct extension to adjacent organs or tissues", will be added to code 11 in the Collaborative Stage System. Neither "mucosal spread to a contiguous organ" or "direct extension into a nearby organ" affect staging. Both are still coded to 11 as long as there are no other sites of lymphoma involvement.
EOD code 80 is poorly written. It does not mean diffuse invovement or multiple tumors in a single organ but rather "diffuse disease in two or more organs." |
2002 |
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20021150 | SEER Guidelines Over Time: Should we apply the current guidelines to previously missed older cases now being reported to the central registry? See discussion. | 1. We receive "straggler" cases for coding that were diagnosed when previous coding schemes and guidelines were applicable. When a specific guideline is in place for a given time period and is later changed in some way, we try to use the specific guideline that was in place at the time of diagnosis when coding the incoming case. However, it is not always possible to remember or to be able to access those old guidelines.
2. There are situations when coding old cases that have no applicable guideline for the older diagnosis years but current SEER documentation informs the coder how to handle the situation. For example, in the SEER Program Code Manual (3rd ed), 3 new guidelines were added for coding of differentiation. There were no guidelines in the previous SEER manual that specifically covered those situations. Should we use the current rules in coding differentiation on the older incoming case? |
Code all fields according to the instructions that were in effect at the time the case was diagnosed. If the old guidelines are unavailable or non-existent, code the case in the current scheme. The year the case was abstracted will indicate that the case was a late entry into the system and that could account for the differences in coding seen by a reviewer. | 2002 |
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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 |
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