| Report | Question ID | Question | Discussion | Answer | Year |
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20010049 | Scope of Regional Lymph Node Surgery: Should this field be coded to "unknown or not applicable" for all hematopoietic morphologies, brain primaries and unknown primaries? | For cases diagnosed 1/1/2003 and after: Code the Scope of Regional Lymph Node Surgery field to 9 [Unknown or not applicable] for all hematopoietic morphologies, brain primaries and unknown primaries. . | 2001 | |
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20010129 | Histology (Pre-2007)--Breast: What code is used to represent the histology "duct carcinoma, colloid type"? See discussion. | Do we use 8480/3 [colloid carcinoma] or 8523/3 [duct carcinoma] mixed with other types of carcinomas? | For tumors diagnosed prior to 2007:
Code the Histology field to 8480/3 [colloid carcinoma] per Rule 4. The lesion is colloid type of ductal carcinoma, not ductal carcinoma mixed with colloid 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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20010084 | EOD-Size of Primary Tumor: Can you code the known size of the residual tumor in a further resected specimen if the size of the tumor in a prior excisional biopsy is unknown? See discussion. | Excisional biopsy is done prior to admission and the tumor size is unknown. Pt is admitted for a mastectomy and the residual tumor size is 5 mm. | For cases diagnosed between 1998-2003:
Code the EOD-Size of Primary Tumor field to 999 [unknown]. The majority of the tumor would have been removed during excisional biopsy and it is possible that the tumor could have been quite large. |
2001 |
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20010022 | Grade, Differentiation--Bladder: Some pathologists use a two component grade system for bladder carcinomas - either low grade or high grade. Should we continue to code these per SEER rules as grades 2 [low grade] and 4 [high grade]? See discussion. | The AFIP website states that this low grade classification corresponds to grade 1/3, while the high grade corresponds to both grade 2/3 and grade 3/3. Using the 3-grade conversion, this would also classify the low grade as grade 2, but would leave the high grade as a toss-up between grade 3 and grade 4. | Continue to code Grade, Differentiation as specified in the SEER Program Code Manual: "Low grade" is coded to 2 and "high grade" is coded to 4. | 2001 |
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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 | |
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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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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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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 |
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20010003 | Histology (Pre-2007)--Prostate: What code is used to represent the histology "prostatic duct carcinoma"? See discussion. | Should the histology be coded to duct carcinoma [8500/3] or endometrioid carcinoma [8380/3]? Prostatic duct carcinoma is defined as endometrioid carcinoma; however, sometimes the pathology report describes the histology as being only "prostatic duct carcinoma." | For tumors diagnosed prior to 2007:
If there is no mention of endometrioid carcinoma in the microscopic description, code the Histology field to 8500/3 [duct carcinoma]. If "endometrioid carcinoma" is mentioned in either the final diagnosis or in the microscopic description, code the Histology field to 8380/3 [endometrioid 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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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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