EOD-Extension--Kidney: If a "tumor thrombus" in a renal vein is discontinuous from the primary tumor in the kidney, is it still coded to 60 [Tumor thrombus in a renal vein, NOS], rather than 85 [Metastasis]?
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 60 [Tumor thrombus in a renal vein, NOS]. A thrombus can be a bolus of tumor cells within a large vein that may or may not still be connected/contiguous with the primary tumor. However, both a discontinuous and contiguous thrombus are coded to 60.
First Course Treatment--Lymphoma: How should an antibiotic regimen such as bismuth or omeprazole, amoxicillin, and metronidazole be coded for a MALT lymphoma of the stomach associated with Helicobacter pylori infection? See discussion.
If we do not count the antibiotic regimen as cancer-directed treatment but this is the only treatment given and the lymphoma disappears, is it problematic to have a cancer status of "no disease" recorded in a patient that supposedly was not "treated"?
Do not code antibiotic regimens as Cancer-Directed Therapy. These drugs are intended to treat the bacteria and not the cancer. This type of treatment is ancillary even if it is the only type of treatment given. You may designate a user-defined field to capture this information if desired. The coding combination of a cancer status of "no disease" and all treatment fields coded to "no treatment" is allowable.
Multiple Primaries (Pre-2007)--Vulva/Vagina: SEER Program Code Manual rule #3 on page 11 states "If a new cancer of the same histology is diagnosed in the same site after two months, consider this new cancer a separate primary unless stated to be recurrent or metastatic. Should vulva and vagina be exceptions to rule #3, as are prostate and bladder?
For tumors diagnosed prior to 2007:
No. There is no exception for vulva or vagina.
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.
EOD Clinical Extension--Prostate: Can you assign code 15 if there is no TURP and no physical exam? See discussion.
[Code 15 = Tumor identified by needle biopsy, e.g. for elevated PSA, (T1c)]
Prostate case: Elevated PSA, Prostate u/s: no abnormal findings, Prostate biopsy: adenocarcinoma. Can this be clinically coded as 15? According to Prostate EOD Coding Guide (6/2001), code 15 requires documentation that the physical exam was negative, but in this case, we have no physical info.
For cases diagnosed 1998-2003:
Code the EOD Clinical Extension field to 30-34 when there is no documentation saying that the physical examination was negative.
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.
Multiple Primaries--Hematopoietic, NOS: When the SEER Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table indicates that a disease is not a new primary, but a pathologist or clinician states that it is a new primary, do we use the physician information or the table?
For cases diagnosed prior to 1/1/2010:If the physician clearly states that this is a new primary, submit it as a new primary. Otherwise, use the Single versus Subsequent Primaries of Lymphatic and Hematopoietic Diseases table.
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.
Histology/Date of Diagnosis--Hematopoietic, NOS: What code is used to represent histology for a June 2001 diagnosis of "myelodysplastic syndrome" followed by a September 2001 bone marrow biopsy diagnosis of "myelodysplasia evolving into an acute leukemic state"?
For cases diagnosed prior to 1/1/2010:
Code the Histology field to 9989/3 [myelodysplastic syndrome] and the Date of Diagnosis field to June 2001.
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-Size of Primary Tumor: Should a 2.0 cm ulcerated mass be coded to 020 or 999 for tumor size? See discussion.
With regard to tumor size, how would SEER interpret "2.0 cm ulcerated mass"? Should this be interpreted as an ulcer, or is it a gross description of the appearance of a mass and therefore acceptable to code tumor size to it?
For cases diagnosed 1998-2003:
If this ulcerated mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field to 020 [2.0 cm] based on the size of this mass in the absence of a more precise tumor size description.
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.
Date of Diagnosis/Histology (Pre-2007)--Breast: When there is a delay between the clinical diagnosis of a malignancy and the surgical resection of the primary site, can the resection be used to code the date of diagnosis, extension, size of the primary tumor, and histology? See discussion.
For example, mammogram March 28th states "certainly represents malignancy." Nothing else done until November 1st when pt presents w/skin retraction on PE and bone mets. A mastectomy November 6th shows "ductal ca w/dermal lymphatic invasion and tumor measuring 3.5 cm."
How is the date of diagnosis, extension, tumor size & histology coded for this case?
For tumors diagnosed prior to 2007:
Code the Date of Diagnosis to March. Code the Histology field to 8500/3 [Infiltrating duct carcinoma]. Histology can be upgraded from a clinical histology to a pathological histology anytime.
For cases diagnosed 1998-2003, in coding extension, you need to assess whether there has been progression of disease or not. If progression of disease is verified, do not code extension using the surgical information from November. Code the extension and tumor size based on the mammogram and physical examination at the time of the mammogram, if available.
If no progression of disease is verified, use surgical information to code extension and tumor size.
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.
An official website of the United States government
Home