| Report | Question ID | Question | Discussion | Answer | Year |
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20150051 | Reportability--Brain and CNS: Is schwannoma of the extracranial part of a cranial nerve reportable? Some cranial nerves, like facial nerve, have intracranial and extracranial branches. |
An extracranial schwannoma is not reportable. The schwannoma must arise on the intracranial part of the nerve to be reportable. |
2015 | |
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20061075 | Multiple Primaries--Lymphoma: Is a diagnosis of mycosis fungoides followed a year later with a biopsy proven diagnosis of anaplastic large T-cell lymphoma stated to represent a transformation of the previous mycosis fungoides reportable as one or two primaries? | For cases diagnosed prior to 1/1/2010: This is one primary. Code the histology according to the original diagnosis, mycosis fungoides. The physician states that this one disease process started as mycosis fungoides and progressed into lymphoma. A physician's statement has priority over other sources in determining the number of hematopoietic primaries. In October 2006, a committee will begin working on multple primaries among hematopoietic diseases. The committee will provide further guidance on dealing with disease transformation and other issues. 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. |
2006 | |
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20021176 | Histology (Pre-2007)/Multiple Primaries (Pre-2007)--Breast: What code is used to represent histology for a case with a biopsy specimen that reveals "infiltrating ductal carcinoma with ductal carcinoma in situ, comedo subtype, non-extensive" in one quadrant of the breast and a mastectomy specimen with "invasive pleomorphic lobular carcinoma with lobular carcinoma in situ" in another quadrant of the breast? Paget disease is identified in the nipple section. | For tumors diagnosed prior to 2007:
Code the Histology field to 8522/3 [infiltrating duct and lobular carcinoma]. We are choosing the ductal and lobular combination over the Paget disease and lobular combination because it is more important for analysis purposes.
Be careful in using combination codes to code separate tumors in different locations of the same breast as a single primary. Currently there are only three combination codes for the breast that allow for this situation, 8522 [duct and lobular], 8541 [Paget disease and infiltrating duct] and 8543 [Paget disease and intraductal]. Other histologic type differences that occur as separate tumors in different parts of the same breast are coded as multiple primaries.
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 | |
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20021047 | Surgery of Primary Site--Bladder: Do we code "random bladder biopsies" as an excisional biopsy (27) or as no cancer directed surgery (00) even if the only involvement mentioned on the pathology reports is "focal carcinoma in situ"? | Code the Surgery of Primary Site field to 00 [None; no surgery of primary site] when only random biopsy procedures are performed on the bladder. | 2002 | |
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20000428 | EOD-Clinical Extension--Prostate: How do you distinguish between clinical extension codes of 10, 13, 14, and 20 for cases with a benign prostate per digital rectal exam that appear localized after TURP/prostatectomy? Can the clinical extension code of 10 be used if the term "microscopic carcinoma" is noted in the pathology report without also mentioning "foci" or "Stage A" for clinically inapparent tumors? | For cases diagnosed 1998-2003:
When the prostate feels benign and the cancer is found incidentally at the time of the microscopic exam, code the EOD-Extension field to 10 [number of foci or % of involved tissue not specified]. Code as 13 (less than or equal to 5%) or 14 (greater than 5%) if percentage involved is given in the tissue resected. If the path report states "solitary focus of carcinoma" without mentioning the total amount of tissue resected, code extension to 13. If there is more than one focus, code extension to 10. Don't assign a code of 20 unless the tumor is clinically apparent. |
2000 | |
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20000512 | EOD-Extension/EOD-Lymph Nodes--Kaposi Sarcoma: What code is used to represent this field for a Kaposi sarcoma with no skin lesions but positive lymph node and bone marrow biopsies? | Code the EOD-Extension field to 13 [Visceral (e.g., pulmonary, gastrointestinal tract, spleen, other)], because of the positive bone marrow. Code the EOD-Lymph Nodes field to 3 [Both clinically enlarged palpable lymph nodes (adenopathy) and pathologically positive lymph nodes], for the pathologically positive node.
Note: Potential revision of the extension scheme will be referred to SEER Medical Advisory Group (SMAG). |
2000 | |
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20130155 | Diagnostic confirmation--Heme & Lymphoid Neoplasms: How do we code diagnostic confirmation if the pathology report states the diagnosis of a skin biopsy is "low-grade B cell lymphoma, most compatible with marginal zone lymphoma," genetic data includes positive rearrangement for immunoglobulin heavy chain gene favor a diagnosis of "B cell lymphoma," and the physician's clinical diagnosis is "cutaneous marginal zone lymphoma"? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code diagnostic confirmation to 3 [positive histology AND positive immunophenotyping studies (9590/3 - 9992/3)].
Immunoglobulin heavy and light chain genes rearranged is listed under Genetics Data in the Heme DB for 9699/3 [extranodal marginal zone lymphoma]. Given the documentation of this positive genetic finding and the positive bone marrow, code diagnostic confirmation to 3.
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 | |
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20100111 | Histology--Heme & Lymphoid Neoplasms: How is this field coded for a "myeloma, plasmablastic variant"? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code histology to 9732/3 [multiple myeloma]. The plasmablastic subtype/variant does have a prognostic indication, but the disease is still coded as multiple myeloma.
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. |
2010 | |
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20021142 | Date of Diagnosis: If an originally diagnosed "benign" tumor is later discovered to have "metastasized", should the date of diagnosis be back-dated to the date the original tumor was discovered or to the date the metastatic disease was identified? | Code the Date of Diagnosis field to the date the malignancy is diagnosed. If there was a medical or pathologic review of the original benign diagnosis that indicates that the patient had cancer at the earlier time, then the earlier date is coded as the date of diagnosis. If no medical or pathologic review of the original benign diagnosis is done, then code the date of diagnosis to the date the metastasis is discovered. | 2002 | |
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20031098 | Multiple Primaries (Pre-2007)/Date of diagnosis--Cervix: How is this field coded when initially carcinoma in situ is diagnosed by biopsy and at a later date invasive tumor is found pathologically? | For tumors diagnosed prior to 2007:
Since carcinoma in situ of the cervix is not reportable to SEER (as of 1/1/1996), the diagnosis date is the date of the invasive diagnosis.
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 |
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