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For tumors diagnosed prior to 2007:

Assign 8046 [non-small cell carcinoma] for "non-small cell carcinoma" of the pancreas. If necessary, override any site/type edits.

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.

For tumors diagnosed prior to 2007:

Code "chromophil" to 8260 [papillary renal cell]. According to our pathologist consultant, in the case of chromophil, most authors regard this as more or less synonymous with papillary renal cell [8260]. "More or less" because papillary is an old term descriptive of the microscopic structure, while chromophil is newer and based on the cytology; because most of the latter are papillary the current usage assumes them to be equivalent.

1) The diagnosis "renal papillary (chromophil) carcinoma" tells us that the pathologist who wrote it was seeing both pattern and cytologic features, and is regarding papillary equivalent to chromophil; thus, code to 8260.

2) Code "chromophil renal cell carcinoma" to 8260.

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.

Code tomotherapy as 1 [Beam radiation].

Tomotherapy is external beam radiation therapy. It is a type of IMRT. Intensity-modulated radiation therapy (IMRT) is an advanced mode of high-precision radiotherapy that utilizes computer-controlled x-ray accelerators to deliver radiation. Tomotherapy is a CT image guided IMRT.

Assign code 9380/1 [glioma, borderline].

According to our pathologist consultant, the term pituicytoma is restricted to low-grade glial neoplasms of the neurohypophysis or infundibulum. The best category currently available for these is glioma.

For cases diagnosed 2007 or later, assign code 8340 [Papillary carcinoma, follicular variant] according to rule H15 for Other Sites.

"Predominantly" and "type" indicate specific histologies. "Variant" does not. See rule H13. The histology in this case is papillary and follicular. Tall cell variant is ignored.

Surgery of Primary Site codes 30-33 under "skin" are used for various types of biopsies followed by a gross excision of the lesion. The two procedures (biopsy and gross excision) may be performed on different days, at different facilities, by different physicians as long as both procedures are performed during the first course of treatment.

Answer applies to both pre-2002 and 2003+ surgury code definitions.

For cases diagnosed 1998-2003:

Code EOD-extension to 30 [localized, NOS]. This is mucosal spread (since there is no muscle in the uvula). Soft palate and uvula are handled as a single site, and extension from uvula to soft palate is not addressed in EOD.

Do not report primary acquired melanosis with atypia.

According to our expert pathologist consultant, "There has been a lot of debate in the literature about the diagnostic criteria, terminology, and natural history of primary acquired melanosis [PAM]. Your case comes down squarely on the main issue, which is whether PAM with atypia should be regarded as melanoma in situ. In most studies it appears that PAMs with no atypia or mild atypia do not progress to melanoma, and only a small percentage of those with severe atypia do so."  "PAM, even with atypia, is not melanoma in situ, and should not be reported."

For further information, see this article for a review of a large number of patients: Shields, Jerry A, Shields, Carol L, et al. Primary Acquired Melanosis of the Conjunctiva: Experience with 311 Eyes. Trans. Am Ophthalmol Soc 105:61-72, Dec 2007.

Do not include the disease in the sequencing if the original hematolymphoid disease was not reportable at time of diagnosis.

The 2025 SEER Manual Sequence Number--Central Coding Instruction 1.a advises: A ‘reportable’ primary refers to the site/histology/behavior of the tumor and the years when reporting was required. Review of the reportability requirements in effect during the diagnosis year will be needed.

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 CS extension code 54 [Blood vessel(s) major]. The inferior vena cava is one of the major blood vessels.

The inferior vena cava is located just behind the head of the pancreas. The hepatic artery, the superior mesenteric vessels and the portal vein are nearby.