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Report Produced: 02/14/2026 12:47 PM

Report Question ID Question Discussion Answer Year
20190074

First course treatment/Scope of Reg LN Surgery--Breast: How is Scope of Regional Lymph Node Surgery coded when there is a sentinel lymph node biopsy (SLNBx) and intra-mammary nodes removed for a single primary? See Discussion.

Example: Operative report documents a left breast skin sparing mastectomy and sentinel node biopsy procedure. Pathology report lists left axillary sentinel nodes in specimen A) with 0/2 nodes positive, and left breast mastectomy without axilla in specimen B) yielding an additional 0/2 intramammary nodes positive. Would the Scope of Regional Node Surgery be coded as 2 (SLN biopsy) to capture the intent of the sentinel node procedure only, or 6 (code 2 + 4) to capture the actual type and number of nodes removed?

SEER Coding and Staging Manual includes Scope of Regional Lymph Node Surgery instruction 4.b. which mentions assigning code 4 to intra-organ node removal. Similarly, there is instruction for coding SLN biopsy as code 2 and SLN biopsy with axillary dissection at the same time (code 6) or during separate procedures (code 7). However, it is not clear this combination code is how we should also capture an incidental intra-organ node removal.

Revised answer 07/11/2023

Assign code 6, Sentinel node biopsy and code 3, 4, or 5 at same time or timing not noted. There were two sentinel lymph nodes removed (code 2) plus two intramammary nodes removed in a separate specimen from the mastectomy (code 4). Assign code 6 when nodes are removed from a sentinel lymph node procedure at the same time as removal of intra-organ lymph nodes which were not part of the sentinel lymph node procedure.

 2019
20190079

Reportability/Histology--Pancreas: Is mucinous cystic neoplasm of pancreas reportable?

Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with low or intermediate grade dysplasia is NOT reportable.

Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with high grade dysplasia is reportable. For neoplasms of the pancreas, the term MCN with high grade dysplasia replaces the term mucinous cystadenocarcinoma, non-invasive.

 2019
20190057

Reportability/Histology--Penis: Are and (PeIN) equivalent to PeIN3 and thus reportable? See Discussion.

Appendix E1 of the 2018 SEER manual references a similar diagnosis as being reportable for vulva and vagina only. However, the WHO Classification of Tumors of the Urinary System and Male Genital Organs (4th ed) does include high grade penile intraepithelial neoplasia as a synonym for 8077/2.

Penile intraepithelial neoplasia, grade III (PeIN III) and squamous cell carcinoma in situ of the penis are reportable. If possible, query the physicians as to whether "high grade penile intraepithelial lesion" or are synonymous with one of the reportable terms. If no further information can be obtained, report the case as C609 8077/2, and use text fields to document the details.

 2019
20190089

Solid Tumor Rules (2018)/Histology--Lung: Rule H3 of the Solid Tumor Rules was added to capture non-small cell carcinoma modified by ambiguous terminology when the physician confirms the ambiguous term as the histologic diagnosis, also included in Coding Histology instruction 3.B. If differentiation and features are not included in the histology term, does instruction 2 takes precedence? See Discussion.

For example, pathologic diagnosis is non-small cell carcinoma with squamous features. The medical oncologist describes this as squamous cell carcinoma and begins treatment regimen. As I interpret the rules, we would use code 8046, non-small cell carcinoma, because of instruction 2 and the fact that features is not included in the list of ambiguous terminology.

Code 8046 using Coding Instruction 2 that says to: Code the histology described as differentiation or features/features of ONLY when there is a specific ICD-O code for the "NOS with ____ features" or "NOS with ____ differentiation."

Note: Do not code differentiation or features when there is no specific ICD-O code.

In the example, no ambiguous terminology is used. If ambiguous terminology is used indicating a more specific term, you would code to the specific histology.

 2019
20190009

First Course Treatment/Surgery of Primary Site--Breast: How is "Goldilocks," also referred to as oncoplastic reconstruction, in the surgery section for breast cancer patients coded?

Code Goldilocks mastectomy in Surgery of Primary Site. Breast surgery code 30 seems to be the best available choice for "Goldilocks" mastectomy. It is essentially a skin-sparing mastectomy with breast reconstruction. The choice between code 30 and codes in the 40-49 range depends on the extent of the breast removal. Review the operative report carefully and assign the code the best reflects the extent of the breast removal.

 2019
20190035

Reportability/Histology--Vulva/Penis: Are differentiated penile intraepithelial neoplasia (C60._) and differentiated vulvar intraepithelial neoplasia (C51._) reportable for cases diagnosed 2018+? See Discussion.

We previously downloaded the 8/22/2018 ICD-O-3 histology update tables which included the note, not reportable for 2018, for both of these terms (with an updated histology 8071/2). SINQ 20180020 confirms differentiated penile and vulvar intraepithelial neoplasia are NOT reportable for 2018 (as does 20160069). However, when looking at the 8/22/2018 ICD-O-3 histology update table today, the not reportable for 2018 comment has been removed and it appears these two terms are reportable. Which is correct?

Report differentiated vulvar intraepithelial neoplasia and differentiated penile intraepithelial neoplasia (8071/2). The 2018 ICD-O-3 Coding Table errata dated 8/22/2018, lists the summary of changes of 7/20/2018, stating that these were erroneously flagged as not reportable and the flag was changed from not reportable to reportable (N to Y).

We will update SINQ 20180020.

 2019
20190021

Sequence Number Central--Brain and CNS: How is Sequence Number--Central coded for current/recent benign brain/CNS tumors when the patient has a history of an additional non-malignant CNS tumor diagnosed prior to 2004 (when these tumors became reportable to SEER)? See Discussion.

We are confused by the SEER Program Coding and Staging Manual 2018 instruction that states: This sequence number counts all tumors that were reportable in the year they were diagnosed even if the tumors occurred before the registry existed or before the registry participated in the SEER Program. Does this rule apply to benign and borderline CNS tumors?

Does this mean that any non-malignant CNS tumor diagnosed prior to 2004 should NOT be included in the sequencing (in the 60s range) if we were collecting non-malignant CNS per our State Registry reporting requirements prior to 2004?

Example: Patient has a March 2017 diagnosis of right sided vestibular schwannoma (C724-1, 9560/0) and a prior history of left sided acoustic neuroma (c724-2, 9560/0) diagnosed in 1991. How should sequence be coded for each primary in our file?

For your example, code the Sequence Number--Central as 61 for the 1991 diagnosis if this was a state registry requirement in 1991 and code 62 for the 2017 diagnosis.

 2019
20190048

Reportability/Histology--Skin: Is malignant hidroacanthoma simplex of the scalp reportable? If so, what is the histology?

Malignant hidroacanthoma simplex of the scalp is reportable. Malignant hidroacanthoma simplex is a synonym for porocarcinoma, 8409/3.

 2019
20190030

Summary Stage 2018/Extension--Prostate: Can imaging be used to code SEER Summary Stage 2018? MRI shows tumor involved the seminal vesicles and the patient did not have surgery. AJCC does not use imaging to clinically TNM stage a prostate case.

Note 5 was changed in Version 2.0.

Per Note 5 of the 2018 SEER Summary Stage Prostate chapter: Imaging is not used to determine the clinical extension. If a physician incorporates imaging findings into their evaluation (including the clinical T category), do not use this information.

This note was changed in Version 2.0 (2021 changes) to be in line with how AJCC stages; therefore, AJCC and Summary Stage agree.

 2019
20190082

Primary site/Histology--Peritoneum: What is the correct primary site code for peritoneal mesothelioma in a female? When I use C482, it seems that the fields are all geared towards primary peritoneal carcinoma with FIGO staging, etc.

For mesothelioma, NOS (9050) and epithelioid mesothelioma (9052) of the peritoneum for females, assign C481, C482, or C488 as appropriate based on the site of origin in the medical documentation. The Primary Peritoneal Ca schema is assigned and you will need to complete the SSDIs for FIGO staging, CA-125 PreTx Interpretation, and Residual Tumor Volume Post Cytoreduction.

If the histology is 9051 or 9053 with primary site of C481, C482, or C488 for females, the Retroperitoneum schema is assigned. The only SSDI for this schema is Bone Invasion.

 2019