Report | Question ID | Question | Discussion | Answer | Year |
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20130219 | Date of diagnosis/Ambiguous terminology--Breast: Can a mammogram BIRADS 4 or 5 assessment be used to assess reportability and can the date of the mammogram be used to code the date of diagnosis? See Discussion. |
Can the BIRADS number be used to assess reportability? Can a BIRADS assessment of "suspicious" be used to code the date of diagnosis? |
BIRADS category 4 and category 5 mammograms are not to be interpreted as a reportable "malignancy" for cancer registry purposes nor are they to be used to code the date of diagnosis should the patient subsequently have a malignancy confirmed. | 2013 |
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20130093 | MP/H Rules/Histology--Lung: What histology code is used for an adenocarcinoma in situ/bronchioloalveolar carcinoma (BAC) of the lung? See Discussion. | Classification of lung malignancies has undergone a change. The bronchioloalveolar carcinoma histology is being replaced by adenocarcinoma in situ and minimally invasive adenocarcinoma, using an evaluation of lepidic growth pattern in the tumor.
The final diagnosis is "adenocarcinoma in situ/BAC" and the comment states, "The findings in the current biopsy are most compatible with low grade malignant lesions which, in this sample, shows features of adenocarcinoma in situ (former bronchioloalveolar adenocarcinoma), given the proliferation of pneumocytes is limited to the alveolar lining with no evidence of invasion. However, classification of the lesion depends, per reference guidelines (Travis et al. J THOR ONCOL 2011 6,(2):244-275), on its size and its overall histologic features, to rule out the presence of an invasive component and therefore can only be performed upon examination of it in its entirety, upon resection." The radiation oncologist staged this T1N0M0, stage 1 BAC. |
Code the histology to 8140/2 [adenocarcinoma in situ, NOS].
The comment for this case is consistent with information from the CAP protocol, which says, "The diagnosis of bronchioloalveolar carcinoma requires exclusion of stromal, vascular, and pleural invasiona requirement that demands the tumor be evaluated histologically in its entirety. It is therefore recommended that a definitive diagnosis of bronchioloalveolar adenocarcinoma not be made on specimens in which the tumor is incompletely represented."
This tumor was not completely resected. Therefore, code to adenocarcinoma in situ based on the information provided. |
2013 |
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20130069 | Reportability--Heme & Lymphoid Neoplasms: Is chronic myeloproliferative neoplasm reportable? See Discussion. | The Heme DB indicates myeloproliferative neoplasm is reportable, but does not indicate whether chronic myeloproliferative neoplasm is. Does the word "chronic" make this non-reportable? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Chronic myeloproliferative neoplasm is reportable. The preferred term is myelodysplastic/myeloproliferative neoplasm, unclassifiable (MPN). Chronic myeloproliferative neoplasm is listed in the Heme DB under the Alternate Names section for this neoplasm.
The term chronic does not affect the reportability of this neoplasm. The newer terms are myeloproliferative neoplasm or myeloproliferative disorder and chronic is not used in most diagnoses.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |
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20130067 | Histology--Heme & Lymphoid Neoplasms: How is histology coded for a pathology report final diagnosis of diffuse large B-cell lymphoma (50%) and follicular lymphoma, 3A (50%)? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to diffuse large B-cell lymphoma [9680/3] per Rule PH11.
Code the histology to 9680/3 [diffuse large B-cell lymphoma] when DLBCL and any other non-Hodgkin lymphoma (follicular lymphoma, grade 3 in this case) are present in the same anatomic location. DLBCL is coded because it is the more aggressive histology.
NOTE: This answer assumes these two histologies are present simultaneously in the same anatomic location. Per Rule M4, this is a single primary.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 | |
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20130091 | Treatment, NOS--Heme & Lymphoid Neoplasms: Which guidelines are used to code treatment for hematopoietic diseases diagnosed prior to 2010? | For cases diagnosed 1/1/2010 and later, use the Hematopoietic & Lymphoid Neoplasm Manual for instructions on coding aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
For cases diagnosed 5/1/2002 12/31/2009, use the instructions in the SEER Manual and the instructions in "Abstracting and Coding Guide for the Hematopoietic Diseases" to code aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
For cases diagnosed 1/1/2001 04/30/2002 use the instructions in the SEER Manual for collection of aspirin, blood thinners/anti-clotting medications, and transfusions in the field "Other Treatment."
Prior to 1/1/2001, these treatment modalities were not collected. |
2013 | |
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20130092 | Reportability--Head & Neck: What are the correct site and histology codes if a glomus tympanicum tumor of the middle ear is reportable? |
Glomus tympanicum tumors of the middle ear are not reportable. The 2005 WHO Classification of Head and Neck Tumors classified these tumors as a borderline [/1] behavior and recorded them in the ICD-O-3 with histology code 8690 [glomus jugulare tumor, NOS]. According to WHO, "the distinction between jugular and tympanic paragangliomas can easily be made in the patient by modern imaging methods ... the jugular neoplasm is identified as arising from the jugular bulb region ... while the tympanic neoplasm is confined to the middle ear." Benign and borderline neoplasms of the middle ear [C301] are not reportable. The middle ear is not a reportable CNS site for benign and borderline tumors. |
2013 | |
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20130150 | MP/H Rules/Histology--Bladder: What is the histology code histology code for a bladder TUR that demonstrates mixed invasive urothelial and small cell carcinoma? See Discussion. |
SINQ 20041104 (prior to 2007 MP/H rules) states to code histology to 8045. The MP/H rules do not address this combination of urothelial and small cell carcinoma. The current MP/H rule that applies is Rule H8, code the higher histology (8120/3). However, if the histology is coded to 8120/3, the fact that small cell carcinoma exists will be lost. If the small cell carcinoma drives the treatment plan/prognosis, shouldn't this situation be reflected in the rules for coding histology? |
Code the histology to 8045/3 [mixed small cell carcinoma]. The presence of small cell carcinoma drives the treatment decisions for this case.
This issue will be addressed in the next revision of the MP/H rules. |
2013 |
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20130218 | 2013 | |||
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20130168 | Date of diagnosis--Heme and Lymphoid Neoplasms: Is the date of diagnosis coded to the date a bone marrow biopsy revealed "plasma cell neoplasm; plasma cells are < 10%" or the date a diagnosis of myeloma was noted in the Discharge Summary? See Discussion. | Bone marrow biopsy pathology states: Plasma Cell Neoplasm. The plasma cells are < 10%.
Subsequent to the bone marrow biopsy, the Discharge Summary indicated the patient has a diagnosis of myeloma, hypercalcemia and negative bone marrow surveys.
What date is used for the date of diagnosis? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Use the date of the Discharge Summary as the date of diagnosis. In this case, the date of diagnosis is the date the physician confirmed the diagnosis of myeloma using all information available.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |
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20130166 | Reportability--Heme & Lymphoid Neoplasms: Is "indolent multiple myeloma" reportable and synonymous with "indolent/smoldering myeloma"? See Discussion. |
7/10/12 Diagnosed with monoclonal gammopathy of undetermined significance (MGUS) 7/27/12 Diagnosed with MGUS/smoldering myeloma. There was no intervention at this time. In about October/November 2012 the diagnosis was reported as smoldering myeloma,. |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Indolent myeloma [9732/3] and smoldering myeloma [9732/2] are reportable terms synonymous with plasma cell myeloma. Monoclonal gammopathy of undetermined significance (MGUS) [9765/1] is not reportable. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2013 |