Report | Question ID | Question | Discussion | Answer | Year |
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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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20021204 | EOD-Size of Primary Tumor--Cervix: When both a depth and diameter of the tumor are provided and the description of the diameter is provided in a range, how do you code the size of the primary tumor? See discussion. | Path states "microscopic focus of endocervical glands considered invasive adenoca...maximum depth of that focus measures approximately 2 mm. Maximum diameter of that focus measures 3-4 mm."
What size would be coded for this case: 999, 002, 003, or 004? |
Code the EOD-Size of Primary Tumor field to 004 [4 mm]. Code the diameter dimension in the EOD-Size of Primary Tumor field and the depth dimension iin the EOD-Extension field. Code the largest number associated if a range is provided for the diameter of the invasive tumor.
If the size of the diameter had not been mentioned, the EOD-Size of Primary Tumor field would have been coded to 001 [microscopic focus or foci only], which ignores the size associated with the depth dimension of the tumor. |
2002 |
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20020039 | Multiple Primaries (Pre-2007)/EOD-Extension--Bladder/Prostatic Urethra: When noninvasive papillary transitional carcinoma of the bladder and invasive papillary transitional cell carcinoma of the prostatic urethra are diagnosed at the same time, and staged by the pathologist as two primaries, should they reported as two primaries? If reportable as a single primary what site code should be used? | For tumors diagnosed prior to 2007:
No. This is one primary. Mucosal spread of noninvasive cancer from a hollow organ (bladder) into another hollow organ (prostatic urethra) is coded as a single primary. The prostatic urethra is seldom a primary site. The cancer usually starts in the bladder and spreads to the prostatic urethra via the mucosa. In this case the cancer in the prostatic urethra became invasive. Code primary site as bladder, NOS [C67.9].
For cases diagnosed 1998-2003: Code EOD Extension using the invasive information (prostatic urethra).
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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20021157 | Histology (Pre-2007)/Grade, Differentiation--Lung: What code is used to represent the histology for a lung biopsy of "non-small cell carcinoma with features of poorly differentiated adenocarcinoma"? See discussion. | Non-small cell carcinoma does not appear to be an NOS term in ICD-O-3. The term "with features of" indicates a majority of tumor. Which rule should be used to code histology? | For tumors diagnosed prior to 2007:
Code the Histology and the Grade, Differentiation fields to 8140/33 [adenocarcinoma, poorly differentiated].
The term "non-small cell carcinoma" is used to represent a broad category of epithelial cancers. Non-small cell carcinoma [8046/3] is grouped in the ICD-O-3 under "Epithelial Neoplasms, NOS." The term can be used by a pathologist when he rules out the fact that the patient has a small cell cancer by stating that the malignancy is a non-small cell type of cancer. In this case, the type of non-small cell cancer present in the specimen is adenocarcinoma.
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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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 |
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20021066 | Histology: How do we code this field when a less representative specimen has a more specific morphology? See discussion. | Example: Biopsy revealed endometrioid adenocarcinoma and the resection demonstrated adenocarcinoma, NOS. Do we code histology per the most representative sample, or to the more specific morphology? | Code the histology using the pathology report from the most representative specimen, even if that histology is less specific. For the case example above, code 8140 [adenocarcinoma, NOS]. The rationale is that a diagnosis from a smaller specimen will be less accurate and less representative of the true histology compared to a larger tumor specimen. |
2002 |
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20020056 | Multiple Primaries (Pre-2007)--Bladder: Is a 1998 transitional cell carcinoma of the bladder, followed by a 2001 squamous cell carcinoma of the bladder reportable as a second primary? | For tumors diagnosed prior to 2007:
Yes. This case is reportable as a second primary. The rule in the SEER Program Code Manual says that invasive bladder cancers with histology codes 8120-8130 [papillary, transitional] are always coded as a recurrence and are an exception to the multiple primary rule. Squamous cell carcinoma [8070] is not a part of that exception.
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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20021059 | Surgery of Primary Site--Soft Tissue: What code is used to represent this field when an excisional biopsy of a soft tissue sarcoma is followed two weeks later with a wide excision (re-excision)? | For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 26 [partial resection]. According to the CoC, "Excision" in the surgery codes refers to the lesion and "partial resection" refers to the organ. The biopsy is a local excision (code 25). The wide resection is code 26, presuming that more than just the remaining lesion was removed. | 2002 | |
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20021094 | EOD-Extension/EOD-Lymph Nodes--Testis: If the patient received chemo, should "bulky retroperitoneal adenopathy" be coded as involved lymph nodes in the EOD lymph node involvement field for a testicular primary treated with an orchiectomy that rendered a path diagnosis of "seminoma confined to the testicle"? See discussion. | Per an orchiectomy path diagnosis a seminoma was confined to the testicle. The only other workup, other than a scrotal ultrasound, was a staging CT scan that revealed bulky retroperitoneal adenopathy in abdomen and pelvis, as well as mediastinal adenopathy. There was also a peripheral pulmonary nodule. No final clinical diagnosis or stage was provided in the chart. Following the orchiectomy the patient was treated with chemo. Should we also have coded distant site lung involvement? | For cases diagnosed 1998-2003, code the EOD-Lymph Nodes field to 9 [unknown] because "adenopathy" is not used to code lymph node involvement. The physician varied from the usual treatment for a localized testicular carcinoma, which is an orchiectomy. The physician proceeded immediately to chemotherapy as further treatment. It is not clear whether the decision to treat with chemo was based on the nodes and/or lung being involved.
Search the record for the physician's opinion regarding distant metastasis. Do not code distant involvement based on a peripheral pulmonary nodule seen on CT without further proof. If no further information is available, code the EOD-Extension field to 99. |
2002 |
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20021014 | Reportability: Is "Castleman's Disease" reportable? | For cases diagnosed prior to 1/1/2010:Castleman's Disease is not reportable to SEER. Synonyms for this disease process include: Castleman-Iverson Disease, benign giant lymph node hyperplasia, and angiofollicular mediastinal lymph node hyperplasia. Castleman's Disease is a rare disorder characterized by non-cancerous growths that may develop in the lymph node tissue throughout the body. The plasmacellular form of this disease may progress to lymphoma or plasmacytoma.
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 |