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Report Produced: 11/25/2024 01:42 AM

Report Question ID Question Discussion Answer Year
20071101 Multiplicity Counter/CS Tumor Size: The Multiplicity Counter rule 6c states "Use code 99 when the tumor is described as diffuse". Is code 99 used in all circumstances when tumor size is coded to 998? See Discussion. The CS manual lists esophagus, stomach, familila/familial polyposis (colon), lung, and breast as the only circumstances when code 998 is valid. If this is correct, then if TS is coded to 998, then Multiplicity Counter must be 99. If the number of tumors is known, code the number in Multiplicity Counter. If the number of tumors is not known, assign code 99. If "diffuse" is the only information available to describe the tumor, assign code 99. 2007
20091124 CS Eval--Lung: How is the CS Reg Nodes Eval field to be coded when the FNA of a paratracheal lymph node is positive for adenocarcinoma and the patient subsequently undergoes neoadjuvant chemoradiation therapy followed by an excision of multiple lymph node fragments that show adenocarcinoma? See Discussion. The CSv1 scheme for lung shows that code 1 under CS Reg Nodes Eval is a path staging basis. However, the definition for code 1 also states that no regional lymph nodes were removed for examination. Would we use code 1 because the case represents path staging basis? If we select code 5 because regional lymph nodes were dissected, the staging basis would be clinical. If we select code 6, the staging basis would be y.

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.

Use code "6" for the CS LN evaluation field. As explained on page 113 in the 2007 SEER Manual, when post-operative disease is more extensive despite neoadjuvant therapy, this can be coded in the evaluation field. In this case, only an FNA was done on lymph nodes pre-operatively, but actual lymph nodes were removed and documented in the post-neoadjuvant excision of the lymph nodes which documented that they are histologically positive -- proving that the neoadjuvant therapy did not work.

 2009
20061013 CS Extension--Hematopoietic, NOS: Can this field be coded to 10 [Localized disease] for an extramedullary plasmacytoma that is limited to an extramedullary primary, such as appendix, given that this histology is not listed as one of the allowable histology/CS extension combinations for this code? See Discussion. The Hematopoietic Diseases scheme for CS lists specific histologies for which CS Extension can be coded to 10. Included is plasmacytoma, NOS [9731/3]. However, extramedullary plasmacytoma [9734/3] is not listed as one of the histologies.

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.Assign code 10 [Localized disease].

Both the 2007 SEER manual (page C-1072) and the CS Version 01.04.00 manual (page II-550) have been updated to include 9734 [extramedullary plasmacytoma] under extension code 10.

 2006
20130095 Grade--Heme & Lymphoid Neoplasms: How is grade coded for acute lymphoblastic leukemia, NOS? See Discussion. The Heme DB indicates histology code 9811/3 [B lymphoblastic leukemia/lymphoma] is the current histology code to use for the now obsolete term of acute lymphoblastic leukemia [9835/3]. The Heme DB entry for histology code 9835/3 states to "Code grade specified by pathologist. If no grade specified, code 9." The Heme DB entry for the current histology code, 9811/3, states to code the grade to 6 [B-cell]. Should grade be coded to 6 [B-cell] for all cases coded to histology code 9811/3?

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

Code the grade to 6 [B-cell] for all cases of 9811/3 [B lymphoblastic leukemia/lymphoma] per Rule G3 in the Heme Manual.

Acute lymphoblastic leukemia, NOS [9835/3] is an obsolete code and cannot be used for cases diagnosed 2010 and later. The Heme DB indicates the correct histology code is 9811/3 and grade 6 [B-cell] for cases diagnosed 2010 and later.

For cases of acute lymphoblastic lymphoma, NOS [9835/3] diagnosed prior to 2010, use the pathology report information to code the grade. Code the grade as 9 [unknown] if the pathology report does not specify the grade.

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
20130069 Reportability--Heme & Lymphoid Neoplasms: Is chronic myeloproliferative neoplasm reportable? See Discussion. The Heme DB indicates myeloproliferative neoplasm is reportable, but does not indicate whether chronic myeloproliferative neoplasm is. Does the word "chronic" make this non-reportable?

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

Chronic myeloproliferative neoplasm is reportable. The preferred term is myelodysplastic/myeloproliferative neoplasm, unclassifiable (MPN). Chronic myeloproliferative neoplasm is listed in the Heme DB under the Alternate Names section for this neoplasm.

The term chronic does not affect the reportability of this neoplasm. The newer terms are myeloproliferative neoplasm or myeloproliferative disorder and chronic is not used in most diagnoses.

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
20021127 Histology (Pre-2007)/Behavior Code--Thyroid: What code is used to represent the histology "micropapillary carcinoma" of the thyroid? See discussion. The ICD-O-3 includes "micropapillary intraductal (C50._)" [8507/2], "micropapillary serous (C56.9)" [8460/3] and "micropapillary transitional cell (C67._) [8131/3] but does not seem to include a micropapillary code for a thyroid primary.

For tumors diagnosed prior to 2007:

Code the Histology field to 8507/3 [micropapillary carcinoma]. According to rule H, the topography code listed in the ICD-O is disregarded if the tumor is known to arise in another site. In this case, the site is thyroid [C73.9] so the topography code of breast [C50._] can be disregarded for this histology. Apply the matrix principle to change the Behavior Code from 2 to 3.

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
20051062 Surgery of Primary Site--Prostate: How is the use of a Laserscope Niagara laser (modulated KTP-YAG laser beam (Niagara 122 prostate vaporization)) coded for prostate primaries? See Discussion. The Laserscope Niagara laser performs an operation similar to the TURP, but there is virtually no bleeding and patients can sometimes go home the same day, most without a catheter. The laser is delivered through a fiber (the thickness of hair) into the cavity via an endoscope inserted through the urethra. When performed as part of the first course of therapy, assign surgery code 15 [Laser ablation] to Niagara laser photovaporization of the prostate. 2005
20130174 MP/H Rules/Histology--Breast: Given that the current MP/H rules do not recognize specific types of lobular carcinoma, should the histology for an invasive pleomorphic lobular carcinoma be coded to 8022/3 [pleomorphic carcinoma] or 8520/3 [lobular carcinoma]? See Discussion. The MP/H rules do not seem to recognize specific types lobular carcinomas. As invasive pleomorphic lobular carcinoma is "a very rare and distinct morphological variant of invasive lobular carcinoma," (ncbi.nim.nih.gov). Is this histology best reflected in code 8022/3 [pleomorphic carcinoma] or 8520/3 [lobular carcinoma]?

Code the histology to 8520/3 [lobular carcinoma].

The 4th Edition of the WHO Classification of Tumors of the Breast now describes five variants of invasive lobular carcinoma. These variants are solid type, alveolar, pleomorphic, tubulolobular, and mixed-type. WHO has not yet proposed new ICD-O codes be assigned to these variants. The upcoming solid tumor (MP/H) revisions will include instructions on coding these variants.

2013
20081069 Multiplicity Counter: Should this field be coded to 99 for cases of familial adenomatous polyposis (FAP)? See Discussion. The MP/H rules state to abstract these cases as a single primary. The Type of Multiple Tumors Reported as One Primary field is coded as a single primary with a value of 32 (FAP with carcinoma), but the Multiplicity Counter seems to be unknown. Assign code 99 [Multiple tumors present, unknown how many] for cases of FAP when the number of tumors is not stated. 2008
20031069 Hematologic Transplant and Endocrine Procedures--Brain and CNS: Is stem cell transplant coded as treatment for medulloblastoma? See Description. The PDQ lists high-dose chemotherapy with autologous bone marrow rescue as treatment for children under three. A case of medulloblastoma that was treated with gross total resection of the tumor, followed by chemotherapy and autologous PBSC (peripheral blood stem cell) transplant. A stem cell transplant does not fit the definition of "treatment" because it does not affect, control, change, remove or destroy proliferating cancer tissue. However, there is a place to code this procedure. Code stem cell transplant under Hematologic Transplant and Endocrine Procedures. Assign code 20 [Stem cell harvest]. 2003