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Report Produced: 07/27/2024 16:36 PM

Report Question ID Question Discussion Answer Year
20000447 Extension/Ambiguous terminology: How should the terms "entrapped by tumor" and "encased by tumor" be interpreted when coding these fields? Each case must be reviewed in its entirety to determine the appropriate coding of these fields. However, in general the terms "entrapped" and "encased" should NOT be interpreted as involvement unless there is other clinical or pathologic evidence to support involvement. 2000
20000440 Grade, Differentiation--Brain and CNS: Can grade IV be implied for brain primaries with the histology of glioblastoma multiforme, even if there is no statement of grade in the path report? See discussion. Dr. Platz has instructed the Iowa registry to code glioblastoma multiforme to grade IV, even when there is no corroborating statement of grade in the path report. This is also supported in some references. Code the Grade, Differentiation field to 9 [Cell type not determined, not stated or not applicable] in the absence of a stated grade on the pathology report. If a grade is stated, code the stated grade. SEER does not recommend adopting the rule in the Discussion. 2000
20000438 EOD-Extension/SEER Summary Stage 2000--Kidney/Eye: What codes are used to represent these fields for simultaneous bilateral Wilms tumor or simultaneous bilateral retinoblastoma?

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 85 [Metastasis] and the SEER Summary Stage 2000 field to 7 [Distant] for both types of tumor. Each kidney and each eye are staged separately in the AJCC, 6th ed., but for SEER we would abstract these diagnoses as one case and code the EOD and stage fields to distant to reflect the involvement of both eyes or both kidneys.

 2000
20000437

EOD-Extension--Lymphoma: Should "bilateral" inguinal lymph node involvement by lymphoma be two chains for the purpose of coding EOD?

Yes. Bilateral inguinal lymph nodes are coded as two chains/regions.

 2000
20000436

Histology (Pre-2007)--Colon: What code is used to represent the histology "adenocarcinoma arising in a papillary adenomatous polyp"? See discussion.

Is "adenocarcinoma arising in a papillary adenomatous polyp" equivalent to adenocarcinoma in a villous adenoma [8261/3] or adenocarcinoma in an adenomatous polyp [8210/3]?

For tumors diagnosed prior to 2007:

Code the Histology field to 8261/3 [adenocarcinoma in a villous adenoma]. In describing colon polyps, papillary and villous are equivalent terms.

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.

 2000
20000433 Diagnostic Confirmation: Is it appropriate to code this field to "radiography" confirmation when a CT scan does not actually contain a diagnosis of malignancy, however, the discharge diagnosis in the medical record of "probable malignancy" is likely based on the abnormal CT findings? See discussion.

10/1/02 CT of Chest: 1) Huge (left) suprahilar mass. 2) Moderate volume loss, left lung. Appearance suspicious of LLL collapse. An infiltrate is seen in the aerated upper lobe as well as pleural effusion. 3) Streaky and nodular changes are noted at the right base that may represent possible lymphangetic spread of tumor.

10/23/02 Discharge Dx: Lung mass, probably carcinoma.

 Code the Diagnostic Confirmation field to 7 [Radiography]. This is appropriate because it was the scan evidence that was used to make the clinical diagnosis. 2000
20000431

Surgery Fields--Multiple sites: What code is used to represent these fields for the following surgical procedures?

1. Tongue, NOS - Hemiglossectomy with lymph node dissection

2. Choroid - Eye enucleation

3. Vulva, NOS - Vulvectomy with bilateral lymph node dissection

4. Gallbladder - Cholecystectomy

5. Lung - Laminectomy with partial removal of tumor

For cases diagnosed 1/1/03 and later:

1. Code Surgery of Primary Site to 30 and Scope of Regional Lymph Node Surgery to 3.

2. Code Surgery of Primary Site to 41.

3. Code Surgery of Primary Site to 40 and Scope of Regional Lymph Node Surgery to 3.

4. Code Surgery of Primary Site to 40.

5. Code Surgical Procedure of Other Site to 4.

 2000
20000430 Histology (Pre-2007)--Colon: What code is used to represent histology when the surgeon describes a sessile polyp and the final path diagnosis is stated as: "Rectal sessile polyp: Invasive moderately differentiated adenocarcinoma" (pathologist does not state that it is "arising in a sessile polyp")?

For tumors diagnosed prior to 2007:

Code the Histology field to 8210/3 [adenocarcinoma arising in a polyp]. The structure in which this adenocarcinoma is arising, is a 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.

 2000
20000429 EOD-Size of Primary Tumor--Breast: For breast cancer cases, is code 002 [Mammography/xerography diagnosis only with no size given (tumor not clinically palpable)] to be used only when there is no work-up beyond a clinical one? See discussion.

Usually when a mammogram has a malignant diagnosis, the tumor is clinically palpable, but occasionally the tumor is not palpable.

For example, on the mammogram, lesions are identified in the breast. PE--the breasts are palpably normal. Breast biopsies--two ductal carcinomas, no statement of size. Mastectomy--no residual. Should the size be coded to 999 rather than 002?

For cases diagnosed 1998-2003:

In the case you provided, code the EOD-Size of Primary Tumor field to 002 [Mammography/xerography diagnosis only with no size given (tumor not clinically palpable)]. A known code in the size field should always take precedence over 999 [Not stated]. Code size from the records in priority order as stated in EOD, from pathology, op report, PE, mammogram, etc. (See EOD for complete instructions.)

Code size as 999 only when there is a clinically palpable lesion with no size stated in the path, PE, or mammogram.

If there is a lesion seen on mammogram that is not clinically palpable, a stated size taken from the path or mammogram would take precedence over code 002; however, if there is no stated size, use code 002 rather than 999.

 2000
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