Report | Question ID | Question | Discussion | Answer | Year |
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20010075 | Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma with a mucinous focus"? See discussion. | Could 8480/3 [mucinous adenocarcinoma] be used to code histology? | For tumors diagnosed prior to 2007:
Code the Histology field to 8140/3 [adenocarcinoma, NOS]. "Focus" does not indicate the majority of tumor per rule C2 on page 2 of the Coding Complex Morph Dx's. The tumor must be at least 50% mucinous, mucin producing, or signet ring to be coded to the specific histology.
We code to the more specific term if there are no qualifying or modifying terms such as: focally, focus, predominantly. If any qualifying words are used, the C1 rule applies, which is to code to the majority of tumor.
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. |
2001 |
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20010145 | EOD-Extension: There is a one to many relationship between T values in TNM staging and SEER EOD-Extension values (one T value can be coded to many extension values). For most situations, we can typically code EOD-Extension to the lowest value in the range available for that T value per the SEER guidelines. But, what happens if another tumor feature, such as tumor size, was involved in the assignment of a T value? See discussion. | Example: Physician stages lung tumor as T2. The lowest extension code, 20, doesn't precisely fit the guidelines for a T2 tumor because the T2 stage may be based on the size of the tumor, which doesn't have anything to do with the EOD-Extension field. Should EOD-Extension be coded to 30 rather than 20? | The criteria for AJCC stage T2 consists of both size and tumor extension values. Size of tumor is recorded in the EOD-Size of Primary Tumor field. If you determine that size is the physician's sole criteria for assigning a T2 value, code an EOD-Extension value that reflects more specific information than 30 [localized, NOS]. Code to 10 or 25, depending on the case.
If the tumor size is not provided, and there is only a clinician statement that describes the lung tumor as a stage T2, code EOD-Extension to 20, the numerically lowest equivalent EOD-Extension code for the lung T2 category. |
2001 |
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20010128 | Multiple Primaries (Pre-2007)--Bladder/Prostatic Urethra: When invasive TCC of the bladder and TCC in-situ of the prostatic urethra are diagnosed at the same time, are they reportable as two primaries? See discussion. | There is no direct extension of tumor from the bladder to the urethra. According to the SEER rules for determining separate primaries, bladder (C67) and urethra (C68) are separate sites. However, it seems that TCC in the bladder and urethra should be reported as a single primary. | For tumors diagnosed prior to 2007:
This is one primary. Mucosal spread of in situ cancer from a hollow organ (bladder) into another hollow organ (prostatic urethra) is coded as a single primary.
This type of mucosal spread of tumor is sometimes referred to as "intramucosal extension" or " in situ component extending to." Mucosal spread can also be expressed as a statement of an invasive component in one organ with adjacent or associated in situ carcinoma in a contiguous organ with the same type of epithelium.
This case represents an invasive bladder tumor with in situ extension to the prostatic urethra. A tumor that is breaking down can be invasive in the center with in situ cancer at its margins. Occasionally, the in situ margin can move into a contiguous organ with the same type of epithelium.
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. |
2001 |
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20010099 | EOD-Extension--Pancreas: How do you code extension when CT scan shows a mass in the head of the pancreas "encompassing" the hepatic branch of the celiac artery? See discussion. | We do not code the term "encompasses" as involvement. However, should we code this case as extension to the peripancreatic tissue, NOS or as unknown? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 40 [Extension to peripancreatic tissue, NOS]. There has to be extension to peripancreatic tissue if the mass encompasses the celiac artery. |
2001 |
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20010135 | Histology--CLL/SLL: If a tissue diagnosis of "small lymphocytic lymphoma" is made six months after an initial blood diagnosis of "chronic lymphocytic leukemia" should the histology be updated from 9823/3 to 9670/3? | For cases diagnosed prior to 1/1/2010:Do not change the histology to small lymphocytic lymphoma (9670/3). The chronic lymphocytic leukemia has advanced/progressed and disseminated into other tissues from the blood during the last six months. If the patient presents with disease in the blood and/or bone marrow only, code to CLL. If a lymph node or other solid tissue is involved initially, code to SLL. For the case cited, the tissue involvement occurred six months after the initial diagnosis and the histology code is not changed to reflect the progression of disease.
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. |
2001 | |
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20010164 | EOD-Size of Primary Tumor--Prostate: If you only have a biopsy and not a resection of the primary site, can you code the size of the prostate nodule demonstrated on digital rectal exam? See discussion. | Example 1: Digital rectal exam reveals 1 cm left side prostate nodule. TRUS-guided biopsy of left side of prostate shows adenocarcinoma. Right side biopsy is negative. Is size coded to 010 or 999?
Example 2: Digital rectal exam reveals 1 cm left side prostate nodule. Bone scan was positive for metastatic disease. Is size coded to 010 or 999? |
For cases diagnosed 1998-2003:
You need path confirmation that a malignancy exists in the prostate before you can code the size of the nodule seen clinically.
Example 1: Code the EOD-Size of Primary Tumor to 010 [1 cm], because the nodule in the prostate is confirmed as cancer by needle biopsy.
Example 2: Code the EOD-Size of Primary Tumor to 999 because there was no pathologic confirmation of malignancy. |
2001 |
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20010132 | Histology (Pre-2007)--Kidney: What code is used to represent the histology "renal cell carcinoma with granular cell morphology"? Kidney primary with diagnosis of renal cell CA with granular cell morphology. Do we code as granular cell carcinoma? Is the term "morphology" synonymous with "type"? See discussion. | Do we code this type of tumor as a granular cell carcinoma [8580/3]? | For tumors diagnosed prior to 2007:
Code the Histology field to 8320/3 [granular cell carcinoma]. Renal cell carcinoma is a non-specific term that has several specific cellular subtypes, one of which is granular cell [8320/3].
Note: Do not code to granular cell tumor [9580/3], which is not a histology related to renal cell carcinoma.
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. |
2001 |
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20010167 | EOD Fields--Lymphoma: Was MALT Lymphoma [9715/3 (ICD-O-2) and 9699/3 (ICD-O-3)] inadvertently excluded from SEER EOD manual, top of page 180? | For cases diagnosed 1998-2003:
Yes. Use the scheme on page 180 for MALT lymphoma. The ICD-O-2 morphology code 9715 was omitted in error. It should have been added when the EOD was printed in 1998. |
2001 | |
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20010006 | Terminology/EOD-Clinical Extension--Prostate: Is "firm" a term that implies clinically apparent prostate disease? See discussion. | PE: Prostate firm on DRE IMP: Rule out prostate cancer |
For cases diagnosed between 1998-2003:
Code the EOD-Clinical Extension field to clinically inapparent. The clinically apparent term list classifies "firm" as "maybe" being involved. If a maybe term such as "firm" is the only description available, code as clinically inapparent. |
2001 |
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20010122 | Primary Site/EOD-Extension/EOD-Lymph Nodes--All Sites: What codes are used to represent these fields for an "extramedullary myeloid tumor (granulocytic sarcoma)" of the colon with positive or negative lymph nodes? |
For cases diagnosed 1998-2003: If only the extramedullary site is involved, such as colon, code the Primary Site field to the site of origin. Granulocytic or myeloid sarcoma is an exception to the rule that all leukemias should be coded to bone marrow as the primary site. Granulocytic sarcoma is a deposit of malignant myeloid cells in a site other than bone marrow (extramedullary). For EOD staging, granulocytic sarcoma [9930/3] is included in the Hematopoietic, Reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms scheme and the Extension field is coded to 10 when the lymph nodes are negative, since it (like solitary plasmacytoma) is a localized deposit of tumor. However, if the regional lymph nodes associated with the extramedullary primary site are involved, code the EOD-Extension field to 80 [Systemic disease] because the disease is no longer an isolated deposit of malignant granulocytes (in other words, it is not localized). The EOD-Lymph Nodes field is coded to 9 regardless of whether or not the lymph nodes are involved because that is the only allowable code for that field. |
2001 |