First Course Treatment: What code is used to represent each treatment modality field when there is no indication that a particular modality of treatment was recommended or started?
Code the individual treatment fields to 0 or 00 [None] when the modality is not addressed in the treatment plan (or when a treatment plan is lacking) and there is no indication that a particular modality of treatment was recommended or started.
Reportability--Hematopoietic, NOS: Is "evolving" multiple myeloma reportable to SEER?
For cases diagnosed prior to 1/1/2010:No, it is not SEER reportable. The diagnosis of "evolving" multiple myeloma could represent a plasmacytoma, plasma cell dyscrasia or another lymphoproliferative disorder. Some of these histologies are SEER reportable, but some are not. Additional information would be needed to determine reportability. If you are unable to obtain more information, the case is non-reportable.
For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.
Behavior Code/EOD-Extension--Colon: Are extension codes 10 [Mucosa, NOS (incl. Intramucosal, NOS)] and 11 [Lamina propria] in situ, in accordance with AJCC stage for this site?
For cases diagnosed 1998-2003: EOD codes 10 and 11 are invasive. SEER, to be compatible with Summary Stage 77 and 2000, calls EOD extension codes 10 and 11 invasive because invasion of the lamina propria is invasion through the lamina propria/basement membrane and therefore invasive.
According to AJCC, the survivial rates for tumors that invade only the mucosa or lamina propria are similar to Tis tumors, so the AJCC classifies them as Tis.
EOD-Extension: General instructions, page 7, note 3 states: " Extent of disease information obtained after treatment with neoadjuvant chemotherapy, hormone or immunotherapy has begun may be included." Because the SEER manual does not mention radiation treatment, can we use information from a lobectomy to code EOD if a patient has neoadjuvant radiation therapy?
Radiation therapy was inadvertently omitted from the list. Please see SINQ 20031012 answer as to when the surgical information can be used to stage the case.
Grade, Differentiation--Bladder: If the only indication of grade for a bladder primary is "grade 2, NOS," and we do not know the grading system being used by the pathologist, is the numeric grade 2 coded?
See the General Coding Rules on page 92 of the 2004 SEER Manual for instructions about coding grade.
If the only information available is "Grade 2," assign code 2 [Grade II].
CS Extension--Head & Neck: If a 2 cm left tonsil primary extends to the lateral aspect of the soft palate, should extension be coded to 40 [Soft palate, inferior surface including uvula or soft palate NOS] or 42 [Soft palate, superior (nasopharyngeal) surface] for a tonsil primary?
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.
Extension code 40 is for extension from the tonsil to the back (lower) part of the soft palate, or soft palate, NOS. Code 42 is for extension to the front (higher, nasopharyngeal surface) part of the soft palate.
Inferior soft palate is the back (lower) part of the soft palate (C051). Superior soft palate is the front, (nasopharyngeal surface) of the soft palate (C113).
Scope of Regional Lymph Node Surgery--Breast: How should this field be coded when a mastectomy that removed 3 sentinel lymph nodes is later followed by an axillary lymph node dissection that removed 17 lymph nodes? Should all of the lymph node information be coded to this field, even though the Number of Regional Lymph Nodes Examined field will be coded to the number of lymph nodes from the most definitive surgery (17)?
For cases diagnosed 1/1/2003 and after: Yes, all of the lymph node information should be coded to the Scope of Regional Lymph Node Surgery field using code 7 [Sentinel node biopsy and code 3, 4, or 5 at different times].
The Number of Regional Lymph Nodes Examined field no longer exists for this time frame.
CS Reg LN Pos/Exam--Colon: For a patient with both a prostate and colon primary, if the pathology report indicates that 2 of the 3 regional lymph nodes to the colon are positive for a prostate malignancy, how should these fields be coded for the colon primary?
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.For the colon primary, code Reg LN Pos 00 [all nodes negative]. Code Reg LN Exam 03 [three nodes examined].
Three lymph nodes were examined and found to be negative for metastatic colon cancer.
CS Lymph Nodes/CS Site Specific Factor--Breast: When there are no lymph nodes removed and none palpable for an inflammatory breast cancer and the physician stages the case Nx, is the CS Lymph Node field code to 00 [None, no regional lymph nodes involved] or 99 [Unknown, not stated] and would SSF 4 and 5 be coded to 000 [Regional lymph nodes negative...] or 888 [Not applicable]?
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 Lymph Nodes 00 [clinically negative]. See note 3 for CS Lymph Nodes.
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