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.
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.
Histology--Prostate: We are seeing numerous pathology reports with the following diagnosis: "Conventional (acinar) prostatic adenocarcinoma (M81403)." What is the correct histology code?
For cases diagnosed prior to January 1, 2007, assign histology code 8550/3 [Acinar adenocarcinoma].
EOD/Summary Stage--Eye: How is stage coded for a patient with extranodal non-Hodgkin lymphoma involving bilateral choroids (single focus, both sites) and no lymph node involvement? Since the eyes are a paired site, is this two separate extranodal sites? If so, there are no Summary Stage or EOD tumor codes that best fit this scenario.
Assign as Stage IV as recommended by our expert hematological oncologist. This is a rare occurrence and this type of presentation does not fit the definition of intraocular extension. Stage IV is probably the best stage for this type of presentation, since there are two extranodal organs involved, even though they involve a bilateral site.
Reportability/Histology--Pituitary Gland: How are Rathke cleft cyst and Rathke pouch tumor distinguished and are they both reportable?
Rathke cleft cyst is not reportable. Cysts are not neoplastic. However, Rathke pouch tumor (C751, 9350/1) is a reportable neoplasm for cases diagnosed 2004 and later. The Rathke pouch is coded to the pituitary gland. Benign and borderline pituitary tumors have been reportable since 2004.
MP/H Rules--Breast: What histology code is used for lobular carcinoma, pleomorphic type?
For cases diagnosed 2007 or later, use rule H14 and code the histology 8520 [lobular carcinoma]. 8520 is the only ICD-O-3 code for lobular carcinoma. There are no codes for specific lobular types.
Histology (Pre-2007): Is 8524 [lobular mixed with other carcinoma] or 8490 [signet ring cell carcinoma] used to represent a diagnosis of "infiltrating lobular with signet ring features?"
For tumors diagnosed prior to January 1, 2004:
According to our pathologist consultant, for this specific case, code to 8490 [Signet ring cell carcinoma].
Our pathologist states: "Signet ring cell carcinoma is most often a variant of lobular carcinoma (as it appears to be in this case - it is less frequently a variant of ductal), and I think it's appropriate to code it as such. Coding to lobular would also be ok, though that would lose the special feature of the signet ring cells. I would rather not code to 8524, since it is not really a mix of lobular and something else."
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.
Surgery of Primary Site--Brain and CNS: What procedure code would be used for NeuroBlate Laser Interstitial Thermal Therapy? This procedure was used for a Glioblastoma of the brain.
If a pathologic specimen is not taken during this procedure, code in the surgery field using code 10 (Local tumor destruction, NOS). If specimen is sent to pathology, code 90, surgery, NOS. We will request this procedure be included in future treatment field coding documentation.
Our research notes that this procedure, also known as LITT (Laser Interstitial Thermal Therapy), is a surgical treatment. Lasers transmit heat to coagulate or destroy the brain tumors from the inside out.
EOD-Extension--Colon: How should this field be coded for "adenocarcinoma penetrating through bowel wall into adjacent adipose tissue?
For cases diagnosed 1998-2003: The difference between EOD-extension codes 40 and 45 is the level of the fat involved. Code 40 is subserosal fat immediately adjacent to the muscular wall of the colon inside the serosa/visceral peritoneum. Code 45 is pericolic fat in areas where there is a serosal surface or in the retroperitoneal areas of the ascending and descending colon where there is no serosa. Code 42 was added for use when it is not possible to determine whether subserosal fat or pericolic fat is involved. Code 42 should be used only when there is a reference to 'fat' (NOS) The answer for the case example above depends on the location of the primary and whether the fat referred to is within or outside the entire thickness of the colon wall. If no additional information is available, use code 42 [Fat, NOS].
An official website of the United States government
Home