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Report Produced: 02/12/2026 22:59 PM

Report Question ID Question Discussion Answer Year
20051139 Date of Diagnosis--Lung: Should the diagnosis date be coded to the date of the scan or the date of the resection when there is a negative biopsy that occurs between the two procedures? See Discussion.

11/2003 CT chest: 2 cm LLL mass should be considered carcinoma until proven otherwise.

2/2004 CT Chest: stable LLL mass still consistent with primary or metastatic lung neoplasm

11/2004 CT chest: LLL mass suspicious for slow growing carcinoma

3/2005 FNA L lung: atypical cells

4/2005 L lobectomy: well-diff adenocarcinoma

 Code the date of diagnosis as 11/2003. A clinical diagnosis was made on 11/2003 and this is the earliest date of diagnosis for this case. 2005
20051036 Date of Diagnosis--Sarcoma: Should the date of diagnosis be coded to the date of biopsy or the date of birth for an infant biopsied at 3 days of age and stated to have a diagnosis of congenital alveolar rhabdomyosarcoma, widely metastatic?

Code the date of the biopsy as the date of diagnosis. This is the date the cancer was first identified by a medical practitioner.

Note: SEER collects the Month and Year of diagnosis. The "day" of diagnosis is not collected by SEER.

 2005
20130219 Date of diagnosis/Ambiguous terminology--Breast: Can a mammogram BIRADS 4 or 5 assessment be used to assess reportability and can the date of the mammogram be used to code the date of diagnosis? See Discussion.

  1. Assessment: BIRADS category 4-suspicious. Findings are considered suspicious/indeterminate for malignancy

  • Assessment: BIRADS 5- highly suspicious. Findings are highly suggestive of malignancy.

  • Assessment: BIRADS 4- suspicious abnormality consider biopsy

    • Can the BIRADS number be used to assess reportability? Can a BIRADS assessment of "suspicious" be used to code the date of diagnosis?

    		BIRADS category 4 and category 5 mammograms are not to be interpreted as a reportable "malignancy" for cancer registry purposes nor are they to be used to code the date of diagnosis should the patient subsequently have a malignancy confirmed. 2013
    		20061049 Date of Diagnosis/Ambiguous Terminology--Lung: Would the date of a PET scan that states there is a mass in the lung which is "in the range of malignancy " be coded as the date of diagnosis or would the date of a subsequent bronchoscopy with biopsy be used for diagnosis date because it confirms a malignancy?

    The date of diagnosis in this case is the date of the bronchoscopy with biopsy.

    "In the range of malignancy" is not one of the ambiguous terms that are reportable. Please see the list of reportable ambiguous terms on page 3 of the 2004 SEER manual. Do not accession cases based on ambiguous terms not found on the reportable list.

    		 2006
    		20031182 Date of Diagnosis/Diagnostic Confirmation: How are these fields coded when a physician statement of diagnosis predates a positive biopsy? See Description. A mass seen on EGD with negative biopsy 12/28/01. Needle core biopsies 1/14/02 were diagnostic of GIST. Gleevec treatment was initiated 2/02, and in discharge summary 5/27/02, the physician says the GIST was diagnosed on EGD. Code the date of diagnosis as 01/2002. Code the diagnostic confirmation as positive histology. EGD revealed a "mass." Biopsies of the "mass" seen on EGD were negative before January 2002. 2003
    		20021139 Date of Diagnosis/EOD-Extension--Placenta: How do you code these fields for a patient who presents with a vaginal metastatic lesion for a placenta primary? Should EOD-Extension be coded to 60 [Other genital structures NOS: vagina, ovary, broad ligament, fallopian tube] or 85 [metastasis other than lung]? See discussion. Pt had D&C Feb 5 with features of complete mole. On March 7, pt seen for a mass just inferior to the urethral meatus. At path, vaginal introitus fragments were consistent with choriocarcinoma. At time of March 23 admit for chemo, history is given as large hydatidiform mole evacuated Feb 5. Her beta hCG titers initially fell but approximately one month later hCG titers rose. At that time, she had an obvious vaginal metastatic lesion. For cases diagnosed 1998 or after: Code the Date of Diagnosis field to March 7, which is the date that the choriocarcinoma was first diagnosed. There was no slide review or clinical statement that the first occurrence was obviously malignant. Therefore, the vaginal mets is not progression and is codeable as extension. Code the EOD-Extension field to 60 [other genital structures, NOS] according to the current EOD scheme for placenta. Even though the mass is discontinuous, it is still included in code 60 per the guidelines of the FIGO system on which the EOD is based. 2002
    		20110058 Date of diagnosis/Flag: Will the Date of Diagnosis Flag ever be used if the instructions for coding Date of Diagnosis are followed? See Discussion.

    If an abstractor follows the instructions for coding the Date of Diagnosis and can at least estimate a year of diagnosis, in what scenario will the Flag be used?

    Per the 2010 SEER Manual,

    Page 49 Date of Diagnosis, second paragraph, "Regardless of the format, at least Year of diagnosis must be known or estimated. Year of diagnosis cannot be blank or unknown." The manual gives the following guidelines for coding diagnosis date/flag:

    Page 50, Coding Instructions:

    3. If no information about the date of diagnosis is available

    a. Use the date of admission as the date of diagnosis

    b. In the absence of an admission date, code the date of first treatment as the date of diagnosis.

    Page 51, Coding Instructions:

    9. Estimate the date of diagnosis if an exact date is not available. Use all information available to calculate the month and year of diagnosis.

    Page 53, Date of Diagnosis Flag, Coding Instructions:

    Always leave blank. Date of Diagnosis will always be a full or partial date recorded.

    		 The date of diagnosis flag should always be blank. 2011
    		20021210 Date of Diagnosis/Histology (Pre-2007)--Breast: When there is a delay between the clinical diagnosis of a malignancy and the surgical resection of the primary site, can the resection be used to code the date of diagnosis, extension, size of the primary tumor, and histology? See discussion.

    For example, mammogram March 28th states "certainly represents malignancy." Nothing else done until November 1st when pt presents w/skin retraction on PE and bone mets. A mastectomy November 6th shows "ductal ca w/dermal lymphatic invasion and tumor measuring 3.5 cm."

    How is the date of diagnosis, extension, tumor size & histology coded for this case?

    For tumors diagnosed prior to 2007:

    Code the Date of Diagnosis to March. Code the Histology field to 8500/3 [Infiltrating duct carcinoma]. Histology can be upgraded from a clinical histology to a pathological histology anytime.

    For cases diagnosed 1998-2003, in coding extension, you need to assess whether there has been progression of disease or not. If progression of disease is verified, do not code extension using the surgical information from November. Code the extension and tumor size based on the mammogram and physical examination at the time of the mammogram, if available.

    If no progression of disease is verified, use surgical information to code extension and tumor size.

    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
    		20031154 Date of Diagnosis/Histology (Pre-2007)/Behavior--Melanoma: How are these fields coded when the first shave biopsy finds "what appears to be the top of a melanoma" and a subsequent shave biopsy finds "features consistent with lentigo maligna?"

    For tumors diagnosed prior to 2007:

    Evaluate each case using all available information, including all pathology reports. Use the date of the first biopsy because it did identify the melanoma. The second biopsy confirmed the histologic type.

    According to WHO's Histological Typing of Skin Tumors, lentigo maligna melanoma is similar to lentigo maligna, but has dermal invasion by atypical melanocytes.

    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
    		20021136 Date of Diagnosis/Histology (Pre-2007): How should we code these fields for "atypical fibroxanthoma" of the left cheek diagnosed in October 1999 that is followed by a June 2000 punch biopsy with a microscopic description in the pathology report of "superficial form of malignant fibrous histiocytoma"? See discussion. Should the diagnosis date for the malignant fibrous histiocytoma be October 1999 because it is called "residual/recurrent atypical fibroxanthoma" in the June 2000 final diagnosis of pathology report? In the microscopic description it is called a "malignant fibrous histiocytoma." Per an August 2000 outpatient note, "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma."

    For tumors diagnosed prior to 2007:

    Code the Histology field to 8830/3 [Malignant fibrous histiocytoma]. Code the Date of Diagnosis to October 1999 based on the clinician's statement of "The patient probably has malignant fibrous histiocytoma. His course has been more aggressive than that seen with an atypical fibroxanthoma." Assume that this statement means that the physician re-evaluated the clinical course and decided that the original tumor must have been malignant.

    If the original slides are reviewed and the diagnosis is changed to a malignancy or if the clinician states that the first occurrence was obviously malignant, backdate the date of diagnosis to the first occurrence.

    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