SEER Inquiry System - Search

According to the 2018 SEER Manual, Sentinel Lymph Nodes (SLNs) Examined and SLNs Positive are included in Regional Nodes (RNs) Examined and RNs Positive when both a sentinel node biopsy procedure and a subsequent dissection procedure are performed or a sentinel node biopsy procedure is performed during the same procedure as the regional node dissection.

Is the instruction under #4.b. on page 114 of the 2014 SEER Program Coding and Staging Manual incorrect? It says to code Rituxan as chemotherapy.  

The patient has gastric cancer and the physician prescribed medical marijuana as treatment. SEER*Rx says marijuana is ancillary as a psychoactive cannabinoid and antiemetic and advises not to code it. The physician specifically wrote "treatment with" in the record. Should it be coded as Other (Code 1) under Other Therapy?

As of 2013, radiofrequency ablation is coded to "radiation therapy," chemoembolization is coded to "chemotherapy," and microwave ablation code to "other."  Or, is coding microwave ablation (using heat not alcohol) coded to surgical code "16"? The latest documentation year that I could find in the SEER website regarding the above was 2013. I would appreciate clarification/confirmation of correct coding especially for microwave ablation.

Per the SEER*Rx Database, Lupron is coded as Other Therapy for breast cancer until such time that it receives FDA approval. However, SINQ 20021042 states Lupron should be coded as Hormone Therapy when given as cancer-directed therapy. These two sources contradict each other.

Information regarding hormone therapy for breast cancer in both the SEER*Rx Database and the National Cancer Institute's Cancer Topics website (http://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet) seem to indicate that the SINQ answer is the correct choice. The NCI Cancer Topics website states that Lupron acts to block ovarian function and is an example of an ovarian suppression drug that has been approved by the FDA. The SEER*Rx Database Remarks section states that a combination of letrozole and leuprolide (Lupron) "is considered standard treatment for metastatic breast cancer and is sometimes used for treatment of early stage breast cancer." But the Remarks go on to state that Lupron should be coded as Other Therapy until it receives FDA approval.

It is unclear how to code Lupron for breast cancers when the NCI website indicates that it is standard treatment while the SEER*Rx Database states both that it is and that it is not standard treatment.

Under the hematopoietic data base, treatment for polycythemia vera shows chemotherapy, immunotherapy, and phlebotomy. Essential thrombocytopenia shows blood thinners, anti-clotting medications, aspirin, chemotherapy, immunotherapy, and other therapy (Anagrelide) (for essential thrombocythemia only) and watchful waiting (for asymptomatic patients). Myelodysplastic syndrome shows bone marrow transplant, chemotherapy, immunotherapy, and stem cell transplant.

SEER*RX under warfarin says: Per the 2012 Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual (page 10), blood thinners and/or anti-clotting agents are to be coded as treatment (Other Therapy) for the following histologies: 9740/4 Mast cell sarcoma 9741/3 Systemic mastocytosis 9742/3 Mast cell leukemia 9875/3 Chronic myelogenous leukemia BCR/ABL 1 positive 9950/3 Polycythemia vera 9961/3 Primary myelofibrosis 9962/3 Essential thrombocythemia 9963/3 Chronic neutrophilic leukemia 9975/3 Myelodysplastic/myeloproliferative neoplasm, unclassifiable.