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Report Produced: 10/17/2025 04:12 AM

Report Question ID Question Discussion Answer Year
20010109 Grade, Differentiation--All Sites: If the grade given for the primary site is from a provisional diagnosis and the grade given for a metastatic site is from a final diagnosis, should we follow the SEER rule that says to code the grade as stated in the final diagnosis (e.g., Provisional diagnosis: High grade papillary serous carcinoma of ovary. Final dx: poorly differentiated adenocarcinoma in a caval lymph node)? Code the Grade, Differentiation field to 4 [High grade] from the examination of the ovary (primary site). Do not code grade from a metastatic site. 2001
20130200 Primary Site--Heme & Lymphoid Neoplasms: What is the primary site for a diffuse large B-cell lymphoma involving the testicles, stomach, rectum and bone marrow, when no lymph nodes are involved?

For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.

Per PH27, code the primary site to C809 [unknown]. Rule PH27 states one is to code the primary site to unknown [C809] when there is no evidence of lymphoma in lymph nodes AND the physician documents in the medical record that he/she suspects that the lymphoma originates in an organ(s) OR there is multiple organ involvement without any nodal involvement.

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
20140086

MP/H Rules/Multiple primaries--Colon: Does rule M7 apply here (A frank malignant or in situ adenocarcinoma and an in situ or malignant tumor in a polyp are a single primary)? Can the frank malignant adenocarcinoma be any specific type of adenocarcinoma for this rule to apply?

A patient has 2 synchronous tumors in the ascending colon. The first is grade 3 adenocarcinoma with signet ring differentiation and focal mucinous features (8255/3). The second is grade 2-3 adenocarcinoma in a tubulovillous adenoma (8263/3).

M7 applies to this case. The frank adenocarcinoma can be a specific type of adenocarcinoma.

2014
20000244 Behavior Code--Bladder/Lymphoma: Should the "in situ" designation on a bladder primary's pathology report be ignored that states a diagnosis of "in situ lymphoma"? Ignore the in situ designation. You cannot assign an in situ behavior code to a lymphoma primary. The term or designation of "in situ" is limited to solid tumors; carcinoma and/or cancer. 2000
20130218 2013
20041011 EOD-Clinical Extension--Prostate: Should this field be coded to 15 [Tumor identified by needle biopsy for elevated PSA] or 30 [Localized, NOS] when the only information is from a biopsy positive pathology report that includes the clinical history of "PSA elevated, DRE negative," with no mention of an ultrasound being performed?

For cases diagnosed 1998-2003: For this scenario, assign code 15 if an ultrasound was not performed, performed and negative, or when it is unknown whether or not an ultrasound was performed. Assign code 30 only if an ultrasound was performed and there is no documentation stating that it was negative or positive.

Please refer to the Prostate EOD Coding Guidelines for all of the instructions pertaining to the coding of prostate EOD.

 2004
20110020 Heme & Lymphoid Neoplasms: How is cancer status to be coded when a patient diagnosed with MDS, undergoes treatment, but the MDS subsequently transforms to AML? If the bone marrow no longer shows evidence of MDS, the cancer status for the MDS is disease-free. When cancer status is coded as disease-free (NED), it means that currently there is no clinical evidence of this disease (MDS). 2011
20031179 EOD-Extension--Stomach: How is this field coded for a stomach primary that has metastases to "Sister Mary Joseph's Nodes?"

For cases diagnosed 1998-2003: For a stomach primary, code extension to 70 [Abdominal wall]. Sister Mary Joseph's nodule is a cutaneous umbilical metastasis most commonly from an intra-abdominal primary.

This rare form of cutaneous umbilical metastasis results from spread of tumor within the falciform ligament. The umbilicus is part of the abdominal wall.

 2003
20021140 EOD-Extension--Head & Neck: How do you code extension for a supraglottic larynx primary with "pre-epigolottic space" invasion?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 65 [Pre-epiglottic tissues]. Extension to "pre-epiglottic space" is equivalent to extension to "pre-epiglottic tissue."

 2002
20000842

Surgery of Primary Site--Skin: Explain the difference between code 30 and code 45.

Code 30 [Biopsy of primary tumor followed by a gross excision of the lesion]

Code 45 [Wide excision or re-excision of lesion or minor (local) amputation with margins more than 1 cm, NOS. Margins MUST be microscopically negative.]

 For cases diagnosed 1/1/2003 and after: Code 30 represents a biopsy or excision in which the margins of excision are less than 1 cm or the margins are unknown. Code 45 represents a wide excision in which it is known that the margins of excision are greater than 1 cm. 2000