Primary Site--Bladder: What subsite is used for fundus of the bladder?
As of November 2005, Code fundus of bladder to C678 [overlapping lesion of bladder]. Opinions vary regarding the definition of bladder "fundus." However, according to our pathologist consultant, fundus includes posterior, anterior and lateral walls and dome. Fundus does not include the trigone.
A correction to page C-595 of the 2004 SEER manual will be included in the next errata.
Reportability/Grade, Differentiation: Does the term "grade 0" refer to differentiation or does its use as a modifying phrase in the final diagnosis of "grade 0 immature teratoma" impact reportability?
Regarding the term "grade 0" for an immature teratoma, determine whether the pathologist is using that term to describe the primary tumor or its implants. The term can be used to describe both situations.
An immature teratoma (IT) may have grade 0 (benign) implants. Grade 0 implants may affect the prognosis and treatment, but the primary tumor (IT) would still be malignant and therefore reportable. If grade 0 pertains to the primary tumor (as opposed to implants) it is benign, and therefore not reportable.
Radiation Therapy--Prostate: Is the regional treatment modality XRT best coded to 50 (brachytherapy, NOS), 53 (LDR) or 54 (HDR) when the documentation indicates only "I-125 seeds" to the prostate?
Assign code 53 [Brachytherapy, interstitial, LDR] for seeds to the prostate. Seeds are always low dose because they are left in place and the radioactivity decays over time.
Reportability/MP/H Rules/Histology--Ovary: What is the histology code for an ovarian tumor described as a mucinous borderline tumor, intestinal type?
Mucinous borderline tumor, intestinal type, of the ovary is not reportable. The behavior is /1. There is no applicable histology code for this histology when it ocurs in the ovary.
CS Size of Tumor/CS Extension--Brain and CNS: How should these fields be coded for benign CNS tumors?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Code CS Extension as 05 [Benign or borderline brain tumors]. Code the size of the tumor if specified. Otherwise code CS Tumor Size as 999 for benign CNS tumors.
Date of Diagnosis: If a clinician states his current diagnosis of malignancy is based on a CT scan done at an early date that contained a diagnosis of only "neoplasm" or "worrisome for carcinoma" should the date of diagnosis be the date of the scan?
Yes. Code the Date of Diagnosis field to the date of the scan. The physician's clinical impression upon reviewing the earlier scan, is that the malignancy was confirmed by the scan. If there is a medical review of a previous scan that indicates the patient had a malignancy at an earlier date, then the earlier date is the date of diagnosis, i.e., the date is back-dated.
Histology (Pre-2007)--Melanoma: Is the code 8740/3 [malignant melanoma in a junctional nevus] to be used when the pathologic diagnosis is "malignant melanoma arising in a compound nevus"?
For tumors diagnosed prior to 2007:
Assign code 8720/3 [malignant melanoma, NOS] for malignant melanoma arising in a compound nevus. A compound nevus is not the same as a junctional nevus.
ICD-O-3 does not have a specific code for melanoma in a compound nevus. Assign the code for the type of melanoma specified; for example, NOS, superficial spreading, etc.
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.
CS Site Specific Factor--Lymphoma: Can the International Prognostic Index (IPI) score be taken from a TNM form in the record? If so, what score would we code for "low" (0-1 points) and "high" (4-5 points)?
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Yes, the IPI score from the TNM form can be used to code SSF 3. Without further information, code "low" as 000 [0 points]. Code "high" as 004 [4 points].
Histology--Melanoma: How is a "malignant melanoma arising in a melanocytic nevus" coded?
The histology code is 8720/3 [malignant melanoma, NOS].
There is no specific code for melanoma arising in melanocytic nevus. According to our pathologist consultant, this is likely because nevi are so common, melanoma arising in association with them is common and appears to have no bearing on prognosis or treatment. Most pathologists do not include the nevus in the diagnosis of melanoma, even when they see it.
Code melanomas arising in melanocytic nevi to the appropriate melanoma code, probably 8720, 8721, or 8743 in most cases.
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