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The Histology Task Force approved a 60 day time frame for ambiguous terminology.

The majority of cases are first identified by ambiguous terminology; for example, a patient has a mammogram that shows a lesion suspicious for cancer. That first indication of cancer prompts a work-up to either confirm or rule-out the cancer diagnosis.

The data item "Ambiguous terminology" is not intended to capture information on this routine method of detecting and diagnosing cancer. The 60 day time frame should keep these cases out of the ambiguous terminology data item.

The data item is intended to identify those cases where the cancer diagnosis is NOT confirmed during the work-up, but the case is still entered into the database. For example a patient who has a TRUS because of elevated PSA. The pathology from the TRUS says "Suspicious for adenocarcinoma of the prostate." The physician only documents that the patient is to return in 6 months for another PSA and TRUS. The registrar would enter this case into the data base because the word "suspicious" is on the ambiguous terminology list.

The definition for code 2 should be "More than 60 days" after the date of diagnosis.

Code 1 is 60 days or less, code 2 is more than 60 days.

This will be clarified in the first revision to the MP/H manual.

There is no strict timeframe for Date of Conclusive Terminology. The diagnosis using conclusive terminology could be made any time following the diagnostic work-up.

The date of conclusive terminology is related to code 2 [ambiguous term followed by conclusive term] in the data item "Ambiguous terminology." Assign code 2 when a conclusive diagnosis is made 60 days or more after a diagnosis using ambiguous terminology. Record the date of the conclusive diagnosis in "Date of Conclusive Terminology."

For cases diagnosed prior to 1/1/2010:Sideroblastic anemia (SA) is not reportable. SA is not the same as refractory anemia with ringed sideroblasts (RARS). Therefore, do not code pyridoxine administered for SA as therapy. If the patient had RARS that "might be due to pyridoxine deficiency," the replacement pyridoxine would not be coded as chemotherapy because it does not control or kill malignant cells. If the pyridoxine was successful in alleviating the refractory anemia, the RARS would be reversible and would not meet the criteria for a reportable blood disease; i.e. irreversible, clonal.

For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

For cases diagnosed 2007 or later, M7 is intended to apply to in situ and invasive melanomas. Therefore, M6 and M7 are repetitive.

This will be corrected when revisions are made to the MP/H rules. In the meantime, both M6 and M7 result in multiple primaries so it does not matter which rule is used.

For cases diagnosed prior to 1/1/2010:Code CMML for this case. Code the histology at initial diagnosis. This patient had rapid progression, but the initial diagnosis was "more compatible with CMML/MPD."

For cases diagnosed 1/1/10 and later, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ.

For cases diagnosed 2007 or later:

Yes. Assign code 9473/3 for tumors arising in the brain and spinal cord and assign code 9364/3 for tumors arising in the bone and soft tissue.

Clarification and reinforcement of this distinction will be added to the "Other sites" terms and definitions with the first revision to the MP/H rules.

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.

"Erosion" is not synonymous with "ulceration" when coding CS extension for breast.