| Report | Question ID | Question | Discussion | Answer | Year |
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20021082 | Multiple Primaries (Pre-2007)/Primary site/EOD-Extension--Head & Neck: How many primaries are represented by an invasive squamous cell carcinoma of the floor of mouth with in situ squamous cell carcinoma involvement of the frenulum? |
For tumors diagnosed prior to 2007: Code the Primary Site field to C04.9 [floor of mouth]. Because the cancer did not INVADE into a neighboring site (through wall, through soft tissue), it just spread along the mucosa (in situ) to involve the frenulum, this is one primary. For cases diagnosed 1998-2003, in situ extension via mucosal spread to the frenulum is ignored for purposes of coding EOD-Extension. 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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20021060 | EOD-Size of Primary Tumor: The EOD Manual instructs us not to code the size of a cyst. Can we code the size of tumor lesions described as being multicystic, multiloculated, or as a complex mass with cystic areas? See discussion. | Example 1: Large multicystic ovarian mass lesion measuring 10 cm. Sections through the specimen show a multicystic and solid mass with abundant fluid exuding from the cut surfaces (Size of the solid portions is not stated).
Example 2: A brain MRI: 9-cm. complex mass with cystic areas. |
For cases diagnosed 1998-2003:
Yes, if the cystic mass is pathologically confirmed to be malignant, code the EOD-Size of Primary Tumor field based on the size of the mass in the absence of a more precise tumor size description. For the examples in the discussion section, code the EOD-Size of Primary Tumor field to: 1) 100 [10 cm]. 2) 090 [9 cm].
As a point of interest, the size of tumor for ovarian and brain primaries is not used in either analysis or as a prognostic indicator for survival. Therefore, spending time separating the cystic and solid portions of the tumor is unnecessary. |
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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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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20020050 | 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. |
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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20021122 | Histology (Pre-2007)--Breast: For a path diagnosis of ductal carcinoma in situ, cribriform type with apocrine features, does the term "apocrine" modify the term cribriform or does it represent another type of ductal carcinoma in situ? See discussion. | It can be difficult to determine if two terms mentioned in a pathology report are describing different aspects of the same morphology or if the two terms are describing two different morphologies. | For tumors diagnosed prior to 2007:
Code the Histology field to 8401/2 [Apocrine carcinoma in situ]. According to our pathologist consultant "Because apocrine is the more unusual tumor, and pulling it out of the cribriform category keeps the latter a little cleaner (because most cribriform ductal carcinoma in situ is not particularly apocrine), I am inclined to code to the histology to apocrine ductal carcinoma in situ."
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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20020063 | EOD-Extension--Breast: How do we interpret "dermal lymphovascular space invasion" and "dermal lymphovascular invasion" for extension? See discussion. | A breast path report states tumor invades dermal lymphovascular spaces. Also, pathologists sometimes state "dermal lymphovascular invasion". Are both these terms synonymous with dermal lymphatic invasion? | For cases diagnosed 1998-2003:
Dermal lymphovascular invasion and tumor in dermal lymphatics would both be coded as dermal lymphatic invasion. |
2002 |
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20021188 | Multiple Primaries (Pre-2007)--Testis: How many primaries should be reported when seminoma is diagnosed simultaneously in both testicles and both tumors are encapsulated? | For tumors diagnosed prior to 2007:
Report this cases as two primaries, unless there is information in the record confirming one primary.
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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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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