Report | Question ID | Question | Discussion | Answer | Year |
---|---|---|---|---|---|
|
20021156 | Primary Site/Histology (Pre-2007): What codes are used to represent site and histology for BSO specimen with a diagnosis, "Left and right adnexa: poorly differentiated serous carcinoma. Comment: The carcinoma occurs as multiple nodules within adnexal soft tissues. Direct involvement of ovaries is not seen, supporting an extraovarian origin." See discussion. | Per our pathologist consultant, the site should be pelvic peritoneum [C481] and the histology is primary serous papillary carcinoma of peritoneum [8461/3]. Does SEER agree? | For tumors diagnosed prior to 2007:
Code the Primary Site to C481 [Specified parts of peritoneum] and the Histology field to 8461/3 [primary serous papillary carcinoma of peritoneum].
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. |
2002 |
|
20031025 | Histology (Pre-2007): Is a small cell undifferentiated carcinoma coded to 8041/34 [small cell carcinoma undifferentiated] or to 8045/34 [combination small cell AND undifferentiated carcinoma] using terms from the 2 columns in Appendix 1 of Coding Complex Morphologic Diagnoses? See discussion. | Per pathology report, diagnosis is small cell undifferentiated carcinoma in biopsies taken from the laryngeal surface of the epiglottis and left false vocal cord. | For tumors diagnosed prior to 2007:
Code histology as 8041/34 [small cell carcinoma, undifferentiated]. The diagnosis indicates that this is an undifferentiated small cell carcinoma, rather than a mixture of small cell carcinoma with undifferentiated carcinoma.
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. |
2003 |
|
20110030 | Reportability--Heme & Lymphoid Neoplasms: If and when did Langerhans cell histiocytosis (LCH) become a reportable neoplasm? See Discussion. | Per the Histiocytosis Association of America, "Over the years, cancer treatments have been used in patients with histiocytosis. Consequently, hematologists and oncologists, who treat cancer, also treat children with Langerhans cell histiocytosis. However, the disease is not cancer." | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Langerhans cell histiocytosis (LCH) [9751/3] is reportable to all agencies starting for cases diagnosed 1/1/2010 and later. See Appendix D: New Histology Terms and Codes.
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. |
2011 |
|
20110078 | MP/H Rules/Histology--Bladder: What is the histology code for "high-grade urothelial carcinoma, plasmacytoid variant"? See Discussion. | Per the MP/H Manual, Urinary Equivalent Terms & Definitions, Table 1, plasmacytoid is a specific type of Urothelial/Transitional Cell Tumor. What is the correct histology, and rule used, when a bladder resection pathology report states, "high-grade urothelial carcinoma, plasmacytoid variant"? | Code the histology to 8082/3 [urothelial carcinoma, plasmacytoid].
The Multiple Primary and Histology Coding Rules Manual is the correct source for coding histology for cases diagnosed 2007 or later. Unfortunately, in this case there is no current rule that directs you appropriately to Table 1 from Rule H7 to find this histology combination. We need to add an example under Rule H7 that instructs you to "See Table 1" for an urothelial carcinoma diagnosis that mentions a more specific cell type (e.g., plasmacytoid). We will add a reference to Table 1 in Rule H7 in the updates to MP/H Rules. |
2011 |
|
20110054 | First course treatment/Other therapy--Heme & Lymphoid Neoplasms: Is a transfusion coded as first course treatment for multiple myeloma? See Discussion. | Per the SEER Manual, First Course for Leukemia and Hematopoietic Diseases definitions, Other Hematopoietic states that transfusions are coded as "other" in the Other Treatment fields. Does this mean that a transfusion for chemotherapy-related anemia is coded as treatment for patients with multiple myeloma? | Do not code transfusions as treatment. According to hematopoietic specialty physicians, transfusions are given for such a variety of reasons (anemia, etc.) and should not be coded as other treatment. | 2011 |
|
20120056 | First course treatment--Corpus Uteri: Should Arimidex be coded as hormone therapy for an endometrioid adenocarcinoma? See Discussion. | Per the SEER Manual, endometrial cancers may be treated with progesterone which is coded as hormone therapy for these primaries. As endometrioid adenocarcinomas are hormonally-dependent carcinomas, should an aromatase inhibitor or anti-estrogen agent also be coded as hormone therapy? | Arimidex has not been approved to treat endometrial cancer. It is not prescribed for pre-menopausal women. Clarify with the physician why the drug was being used. If the physician states Arimidex was given to reduce tumor burden, code as hormone therapy.
See the SEER*Rx interactive database, http://seer.cancer.gov/seertools/seerrx/ |
2012 |
|
20120076 | Multiple primaries/Histology--Heme & Lymphoid Neoplasms: How many primaries are accessioned and what histology codes are used for a 2005 diagnosis of nodular histiocytic lymphoma followed by a 2012 diagnosis of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma? See Discussion. | Per the history and physical, patient was diagnosed in 2005 with nodular histiocytic lymphoma and had chemo at that time. Now the patient presents with enlarged right axillary lymph nodes. A lymph node core biopsy confirmed B-cell small lymphocytic lymphoma/chronic lymphocytic leukemia. Flow cytometry was most consistent with B-cell chronic lymphocytic leukemia. | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case should be accessioned as two primaries per Rule M15. Code the histology for the first primary to 9698/3 [nodular histiocytic lymphoma. Per the Alternate Names section in the Heme DB, this histology is synonymous with follicular lymphoma, grade 3. Code the histology for the second primary to 9823/3 [B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma].
Nodular histiocytic lymphoma does not transform into CLL/SLL (Transformations to), nor does CLL/SLL transform to nodular histiocytic lymphoma (Transformations from). Rule M15 indicates we are to use the Heme DB Multiple Primaries Calculator to determine the number of primaries in this case because none of the rules from 1-14 apply. Per the calculator, the CLL/SLL is a new 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. |
2012 |
|
20081044 | MP/H Rules/Behavior--Melanoma of Skin: How are histology and behavior coded for a "malignant melanoma in situ with regression"? See Discussion. | Per the microscopic portion of the path report, there is a zone of regression within the confines of the lesion, such that the possibility of antecedent invasive disease at the site cannot be ruled out with certainty. | For cases diagnosed 2007 or later: Code malignant melanoma in situ with regression to 8720/2 [Melanoma in situ]. Code the histology according to the histologic type specified in the pathology report final diagnosis. Code the behavior as specified in the pathology report. Regression does not affect the coding of histology or behavior. See Melanoma Histology Coding rule H5. See 2007 SEER manual instructions for coding behavior, page 84. |
2008 |
|
20130204 | MP/H Rules/Histology--Kidney, renal pelvis: How is histology coded for a tubulocystic renal cell carcinoma? See Discussion. | Per the resected specimen final diagnosis COMMENT in the pathology report: Tubulocystic renal cell carcinoma is a relatively new renal epithelial neoplasm that has been added to an updated WHO classification of renal tumors. (Srigley et al. The International Society of Urologic Pathology Vancouver Classification of Renal Neoplasia Am J Surg Pathol. 2013;37:1469-1489). The majority of tubulocystic renal cell carcinomas reported in the literature (greater than 90%) have behaved in an indolent manner. | Code the histology to 8312/3 [renal cell carcinoma, NOS] per Rule H3. The term "tubulocystic" is not a specific renal cell histology according to our kidney pathology expert. | 2013 |
|
20100027 | Reportability: Is AIN III reportable if it arises in the perianal skin? See Discussion. | Physical exam states patient has a suspicious area of anal skin. Operative findings show a raised, suspicious lesion in the right perianal region. Our interpretation of the primary site would be skin and therefore not reportable. However, the final diagnosis on the pathology report indicates "AIN III/squamous cell carcinoma with focal areas suspicious for microinvasion. "SINQ #20041056 states that AIN III is reportable. | AIN III of the anus or anal canal (C210-C211) is reportable. AIN III (8077) arising in perianal skin (C445) is not reportable. | 2010 |