CS Eval/Surgery of Primary Site--Colon: When the only procedure performed is a polypectomy, if there is NO tumor at the margins, should CS TS/EXT-Eval be coded as 3 and the surgery coded as a polypectomy?
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 eval code 3. A polypectomy with no tumor at the margin meets the criteria for pathologic staging.
Code polypectomy in Surgery of Primary site in this case.
Aplastic anemia is not reportable and it is not an alternative name for refractory anemia.
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.
Histology (Pre-2007)--Bladder: How is a "carcinoma with squamous, mucinous, and signet ring cell features" coded?
For tumors diagnosed prior to 2007:
Code histology to 8490 [Signet ring cell carcinoma]. Rule 7 on page 87 of the 2004 SEER Manual applies to this case.
Rule 7: Code the numerically higher ICD-O-3 code. This is the rule with the lowest priority and should be used infrequently.
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.
Histology (Pre-2007)/Terminology: Are "pattern", "architecture", and "architectural pattern" terms that indicate a majority of tumor?
For tumors diagnosed 2004 to 2006:
The terminology "Architectural pattern: ____________," when used in the final pathology diagnosis, indicates a subtype that can be coded. This type of format in a pathology report is based on a College of American Pathologists (CAP) protocol. Disregard "pattern" and "architecture" when not used in accordance with the CAP protocol. See www.cap.org for cancer protocols.
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.
2024 SEER Manual/Primary Site--Breast: Is Primary Site coded as C504 or C501 based on the Solid Tumor Rules and the SEER Manual Breast Coding Guidelines? The pathology report reads "Right Breast 10:00 1 cm from the nipple."
Codes C502-C505 take priority over code C501. The description for C501 in the Solid Tumor Rules has "Area extending 1 cm around areolar complex."
Assign Primary Site code C504 based on the location in the upper outer quadrant of the right breast, 10 o’clock, as opposed to code C501, around the areolar complex. The 2024 SEER Manual Breast Coding Guidelines advise that C502 - C505 are generally preferred over C501 when there is no other way to determine the subsite.
CS Tumor Size--Breast: Is the largest focus or the total area coded for tumor size in a patient presenting with "scattered foci of DCIS, largest focus measuring 0.6cm. DCIS spans a total area of 2.1cm."
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 the size of the largest focus in CS tumor size. Code the tumor size for this case as 006 (6mm or 0.6cm).
Multiple Primaries/Histology (Pre-2007)--Colon: Would one primary be reported when adenocarcinoma arising in a polyp NOS [8210/3] and adenocarcinoma arising in a tubulovillous adenoma [8263/3] were simultaneously diagnosed in the sigmoid colon (first 3-digits of the histology are different)?
For tumors diagnosed prior to 2007:
Code as one primary. Code the Histology field to 8263/3 [Adenocarcinoma in tubulovillous adenoma].
Count as a single primary and code the more specific term when simultaneous lesions are present and one lesion is an "NOS" term and the other is a more specific term. "Polyp" is an NOS term. Adenoma is an associated term, but is more specific (Tubulovillous adenoma is more specific than "polyp").
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.
Date of Diagnosis--Bladder: Should the date of diagnosis be based on the 1/7/04 urine cytology with low grade transitional cell carcinoma or the subsequent 1/27/04 pathology findings of papillary transitional cell carcinoma?
In this case, the date of the cytology is the date of diagnosis, 01-07-2004.
EOD-Extension--Kidney: How would this field be coded when the pathology report shows a 20 mm surface neoplasm with smaller yellow metastatic implants on the surface of the kidney?"
For cases diagnosed 1998-2003: Code extension as 10 [Invasive cancer confined to kidney cortex]. Tumor involves the cortical surface of the kidney with separate surface lesions, but does not extend beyond cortex.
Primary Site/EOD-Extension/EOD-Lymph Nodes--All Sites: What codes are used to represent these fields for an "extramedullary myeloid tumor (granulocytic sarcoma)" of the colon with positive or negative lymph nodes?
For cases diagnosed 1998-2003:
If only the extramedullary site is involved, such as colon, code the Primary Site field to the site of origin. Granulocytic or myeloid sarcoma is an exception to the rule that all leukemias should be coded to bone marrow as the primary site. Granulocytic sarcoma is a deposit of malignant myeloid cells in a site other than bone marrow (extramedullary). For EOD staging, granulocytic sarcoma [9930/3] is included in the Hematopoietic, Reticuloendothelial, Immunoproliferative and Myeloproliferative Neoplasms scheme and the Extension field is coded to 10 when the lymph nodes are negative, since it (like solitary plasmacytoma) is a localized deposit of tumor.
However, if the regional lymph nodes associated with the extramedullary primary site are involved, code the EOD-Extension field to 80 [Systemic disease] because the disease is no longer an isolated deposit of malignant granulocytes (in other words, it is not localized).
The EOD-Lymph Nodes field is coded to 9 regardless of whether or not the lymph nodes are involved because that is the only allowable code for that field.
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