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Report Produced: 07/11/2025 22:48 PM

Report Question ID Question Discussion Answer Year
20010012

Surgery of Primary Site--Breast: What code is used to represent this field for a breast primary treated with a "bilateral mastectomy"? See discussion.

Pt diagnosed with rt breast primary opted to be treated with rt modified radical mastectomy and lt simple mastectomy. Path revealed invasive ductal carcinoma on the rt and ductal carcinoma in situ on the lt. Path reported 14 axillary lymph nodes were found in the mastectomy specimen.

There are two primaries. For cases diagnosed 1/1/2003 and after: For the rt breast, code Surgery of Primary Site to 51. The contralateral left breast malignancy is not involved with the right breast primary by either direct extension or metastasis. Codes 42 and 52 are used to capture prophylactic mastectomy of the opposite noncancerous breast. In this case, the opposite breast has cancer so these codes cannot be used. Code Scope of Regional Lymph Node Surgery to 5 and Surgical Procedure of Other Site to 0.

For the lt breast, code Surgery of Primary Site to 41, Scope of Reg LN Surgery to 0, and Surgical Procedure of Other Site to 0.

 2001
20010100 Grade, Differentiation--Lymphoma/Leukemia: What code is used to represent this field when the phenotype is combined B cell and T cell?

For cases diagnosed prior to 1/1/2010:Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable]. There is no combination code for B cell and T cell. There is also no hierarchy established for choosing one code over the other. Therefore coding such a case as a pure B cell or a pure T cell would misrepresent the phenotype.

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
20010115 Spanish Surname or Origin: If Asians, Blacks and Whites with non-Spanish surnames are born in a Spanish country, is this field coded to Spanish or non-Spanish? See discussion. For example, how do we code Miyako Mitsubishi with race listed as Japanese who was born in Peru or Sylvia Shapiro with race listed as White who was born in Argentina? For both cases, code the Spanish Surname or Origin field to 0 [Non-Spanish/Non-Hispanic]. Persons with non-Spanish surnames would not be coded as being Spanish solely because they are born in a Spanish country. Do not code Spanish ethnicity based only on birthplace. Place of birth is a separate data item and it can be used in data analysis to identify this particular group of people. 2001
20010118 All Surgical Fields/Radiation Sequence with Surgery--Unknown Primaries: What codes are used to represent these fields for an unknown primary treated with a radical neck dissection followed by radiation therapy?

For unknown primaries treated with a lymph node dissection and diagnosed 1/1/2003 and after, code:

1) Surgery to Primary Site: 98 [All unknown and ill-defined disease sites, WITH or WITHOUT surgical treatment].

2) Scope of Regional Lymph Node Surgery: 9 [Unknown or not applicable].

3) Surgical Procedure of Other Site: 1 [Surgery to other site(s) or node(s), NOS; unknown if regional or distant].

4) Radiation Sequence with Surgery: 3 [Radiation after surgery]. Any planned surgical treatment is used to code radiation/surgery sequence (per CoC I&R).

 2001
20010168

Histology (Pre-2007): What code is used to represent the histology "adenocarcinoma, undifferentiated, with sarcomatoid features"? See discussion.

Is the case more accurately coded with histology of adenosarcoma [8933/34] or adenocarcinoma, undifferentiated [8140/34]? Should "sarcomatoid" be interpreted as sarcoma?

For tumors diagnosed prior to 2007:

Code the Histology field to 8140/34 [adenocarcinoma, undifferentiated]. Sarcomatoid means sarcoma-like and should not be used in coding histology.

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
20010019

Reportability--Hematopoietic, NOS: Is the term "plasma cell dyscrasia" a synonym for multiple myeloma?

For cases diagnosed prior to 1/1/2010:

Plasma cell dyscrasia, NOS, is nonreportable. It is not a synonym for multiple myeloma. Plasma cell dyscrasia represents a broad spectrum of disease characterized by plasma cell proliferation that appears inappropriate or uncontrolled. Multiple myeloma is one disease type that falls into that classification. However, there are several other malignant and benign diseases also classified as such because of their immunoglobulin abnormalities. Reportability to SEER regarding a disease classified as a plasma cell dyscrasia is dependent on identifying the specific cell type associated with the disease in the ICD-O-3.

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
20010104 Date of Diagnosis--Lung: Based on Note 7 in the lung EOD, should the Date of Diagnosis field be coded to an earlier CT scan date with a reported diagnosis of "RUL mass with mediastinal lymphadenopathy" or to the later biopsy date with a reported diagnosis of small cell carcinoma? See discussion. Note 7 states that "mediastinal lymphadenopathy" indicates involved lymph nodes for lung primaries. Should the date of diagnosis be back-dated to the date of the scan?

For cases diagnosed 1998-2003:

No, code the Date of Diagnosis field to the later biopsy date. Note 7 is intended for use in coding the EOD-Extension field, not the Date of Diagnosis field. The earlier scan has a diagnosis of RUL "mass" not a "malignancy" so the fact that there is mediastinal lymphadenopathy mentioned in that scan is not used to help determine date of diagnosis.

 2001
20010095 EOD-Extension--Lung: Are "aortico-pulmonary window", "paratracheal space", and "subcarina" coded in the EOD extension field or in the EOD lymph node involvement field? See discussion. Would a lung tumor that extends into the AP window be synonymous with extension into the mediastinum? If so, would this also apply to extension to subcarina, paratracheal space, and other such terms corresponding to areas listed in the mediastinal lymph node field under code 2?

For cases diagnosed between 1998-2003:

Extension into the aortico-pulmonary window, would be coded in the EOD-Extension field as 70 [mediastinal extension]. If the tumor extends into the paratracheal space, subcarina, or other areas listed under the code 2 in lymph nodes, code the EOD-Extension field to 70 to capture this type of involvement.

 2001
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
20010002 EOD-Size of Primary Tumor: How do you code tumor size for lesions described as "at least 2 cm"? See discussion. The expression "at least 2 cm" seems to be different from "greater than 2 cm." Stating "at least" seems to indicate that if the tumor is larger than 2 cm, it is difficult to ascertain the exact tumor size. Should we accept 2 cm as the best info we have, or default to 999 because of the lack of specificity?

For cases diagnosed between 1998-2003:

Code the EOD-Size of Primary Tumor field to 020 [2 cm], using the rule "code what you know."

 2001