SEER Inquiry System - Search

For cases diagnosed prior to 1/1/2010:Code the Primary Site to C08.0 [submandibular gland] and use the surgery code schemes that apply to that site (Parotid and Other Unspecified Glands). Physiologically, lymphoma cells in regional lymph nodes do not "back-flow" into the extralymphatic organ to involve it secondarily. As a result, the primary site is usually the extralymphatic organ with regional lymph node involvement. Do not be afraid to code an extralymphatic site as primary when that site and its regional nodes are involved.

If the lymph nodes are not regional to the extra-nodal involved site and the primary site cannot be determined, code the primary site to C77.9 [Lymph node, NOS].

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.

For cases diagnosed 1998-2003: The data item "Surgery of Primary Site" is intended to record only surgeries of the primary site. If the primary site is unknown or ill-defined, it is impossible to determine whether or not a particular surgery was performed on the primary site. "Surgical Procedure of Other Site" collects much less specific information; however, this is the correct data item to record surgery performed when the primary site is unknown or ill-defined.

For the case example, code the primary site as C76.0 [Head, face or neck, NOS]. Code Surgery of Primary Site as 98 [All unknown and ill-defined disease sites, with or without surgical treatment]. Code Surgical Procedure of Other Site as 1 [Non-primary surgical procedure performed].

For cases diagnosed prior to 1/1/2010:Code the primary site to tonsil (C099). This advanced stage lymphoma involves an extranodal site (tonsil) and that site's regional lymph nodes (cervical). The lymphoma has also spread to non-regional lymph nodes (mediastinal and mesenteric). Code the tonsillectomy as surgery of primary site.

For cases diagnosed 1/1/10 and later, 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.

For the example provided: For 2023 cases and forward, if no part of the surgery was performed, code Surgery of Primary Site 2023 (NAACCR Item #1291) as code A000 or B000 (no surgical procedure of the primary site).  Code Reason for No Surgery of Primary Site (NAACCR Item #1340) as code 2 (surgery of the primary site was not recommended/performed because it was contraindicated due to patient risk factors (comorbid conditions, advanced age, progression of tumor prior to planned surgery, etc.).

In contrast, if any part of the surgery was performed, assign the Surgery of Primary Site 2023 (NAACCR Item #1291) code that best reflects the extent of the surgery performed.  Code Reason for No Surgery of Primary Site (NAACCR Item #1340) as code 0 (surgery of the primary site was performed).

Use text fields to record the details.

For cases prior to 2023, apply the same approach using Surgery of Primary Site (NAACCR Item #1290) instead of Surgery of Primary Site 2023 (NAACCR Item #1291).

First, make sure that the seven lymph nodes removed were actually designated to be sentinel nodes and not a combination of sentinel nodes and other regional nodes. Code sentinel nodes only when the nodes are stated to be sentinel nodes or when the surgical procedure includes the injection of dye to identify sentinel nodes.

If all seven nodes removed are sentinel nodes, follow the instructions in SINQ 20091076 and assign codes 41 [simple mastectomy] and 2 [sentinel lymph node biopsy only].

The SEER Note does not pertain to nodes designated as sentinel nodes.

Surgery of primary site: Assign code 30 [low anterior resection]. Code the most extensive surgery (i.e. the highest surgery code) applicable.

CS Reg LN Exam: Code 04 [four nodes removed].

Scope of regional lymph node surgery: Code 5 [4 or more regional lymph nodes removed].

The sigmoid colectomy was performed for a surgical complication, thus it was not cancer-directed therapy. The regional lymph nodes removed during that procedure were not removed to diagnose cancer or stage the disease, and they were not removed during the initial treatment. Please see SEER manual for instructions for coding Regional Lymph Node Surgery.

Assign code 22 for LUL wedge resection followed by a lingular-sparing LUL lobectomy and mediastinal lymph node dissection.  Code the lymph node surgery in Scope of Regional Lymph Node Surgery. We obtained input from an expert who agrees with this code. He states a lingula-sparing lobectomy is best coded as a segmentectomy because it is the same as an apical trisegmentectomy.

For tumors diagnosed prior to 2007:

The appropriate code for mucinous cystadenoma of the appendix with perforation and pseudomyxoma peritonei is C18.1 8470/0. It is not reportable to SEER. According to our pathologist consultant, mucinous cystadenoma is a legitimate term for such appendiceal tumors. They may implant all over the peritoneum as pseudomyxoma peritonei, especially in the face of perforation, without being histologically malignant.

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.