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Report Produced: 09/15/2025 10:34 AM

Report Question ID Question Discussion Answer Year
20051138 Histology/Reportability--Hematopoietic, NOS: Is "drug induced" myelodysplastic syndrome synonymous with "therapy related" myelodysplastic syndrome? If so, would "drug induced" myelodysplastic syndome be SEER reportable and coded with the histology 9987/3? Page 44 of the "Abstracting & Coding Guide for the Hematopoiectic Diseases" lists this histology & behavior with the proper EOD code to use but yet on page 36 it states "Do not accession the following diagnoses coded to 285.0 and lists secondary SA as well as drug-induced SA.

For cases diagnosed prior to 1/1/2010:

There is considerable difference between therapy-related myelodysplastic syndrome (MDS) and drug-induced sideroblastic anemia (SA).

Therapy-related MDS is the result of irreversible damage to the bone marrow caused by certain kinds of myelotoxic drugs used to treat cancer. Examples are Cytoxan and Etoposide. There is usually a 10+ year delay between the first primary and its treatment and the therapy-related MDS. Therapy-related MDS is not reversible and is reportable as a malignancy. Because the drugs were almost always given to treat a malignancy, therapy-related MDS is almost always a second primary.

Drug-induced SA is not reportable as a malignancy. Drug-induced SA is the result of short term effects of certain drugs on the bone marrow. Drug-induced SA is reversible, as the marrow recovers once the drugs are out of the system.

For cases diagnosed 2010 forward, 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.

2005
20051111 Chemotherapy/Immunotherapy: Which drugs changed categories when SEER*Rx came out?

Please refer to http://seer.cancer.gov/tools/seerrx/

SEER*Rx is effective for cases diagnosed 1-1-2005 and forward. It replaces all previous references. It is neither required nor recommended that cases treated prior to 2005 be recoded.

The following drugs in the 5/17/02 Book 8 update changed from immunotherapy to cytostatic chemotherapy in SEER*Rx:

alemtuzumab/Campath

bexarotene/Targretin

bevacizumab/Avastin

bortezomib/Velcade

pegaspargase/Oncaspar

rituximab/Rituxan

trastuzumab/Herceptin

asparaginase

The following drugs may have been coded as monoclonal antibodies but are radioisotopes in SEER*Rx:

epratuzumab/LymphoCide

ibrituzumab

tiuxetan/Zevalin

tositumomab/Bexxar

Any other monoclonal antibodies either remained as monoclonal antibodies or it was a local decision to code them as immunotherapy.

There were no drugs that changed from chemotherapy to immunotherapy.

 2005
20051011 CS Lymph Nodes/CS Site Specific Factor--Breast: When there are no lymph nodes removed and none palpable for an inflammatory breast cancer and the physician stages the case Nx, is the CS Lymph Node field code to 00 [None, no regional lymph nodes involved] or 99 [Unknown, not stated] and would SSF 4 and 5 be coded to 000 [Regional lymph nodes negative...] or 888 [Not applicable]?

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.

Code CS Lymph Nodes 00 [clinically negative]. See note 3 for CS Lymph Nodes.

Code SSF 4 and 5 000 [Nodes clinically negative].

 2005
20051132 Primary Site/CS Extension/CS Lymph Nodes--Lung: How are these fields coded for untreated lung primaries when only limited information is available from scans, bronchoscopies and biopsies? See Discussion.

3/13/04 CT scan Chest: extensive mediastinal, subcarinal, rt hilar lymphadenopathy; separate tumor mass in medial rt lung

3/16/04 Bronchoscopy: RLL/RML completely obstructed with extrinsic compression. Impression: CA of lung with hilar adenopathy.

Bronchial wash: PD non small cell CA

Bx RLL: up to 0.2 cm PD Adenocarcinoma c/w primary lung CA.

Treatment not recommended.

Expired 5/03/04.

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.

The primary is in the right lung according to the available information.

Assign CS extension code 10 [Tumor confined to one lung]. The only information on extension is that there is a tumor in one lung.

Assign CS Lymph Nodes code 20 [Mediastinal and subcarinal lymph node involvement]. The CT scan confirms mediastinal and subcarinal lymphadenopathy.

Code tumor Size as 999 [Unknown]. "Completely obstructed" is not a size. Do not code the size of the biopsy specimen.

 2005
20051089 2004 SEER Manual Errata/Grade--Breast: Are the codes on page 94 of the SEER manual's Breast Grading Conversion Table requiring conversion of nuclear grades 1/3 and 1/2 to code 1, 2/3 to code 2, and 2/2 and 3/3 to code 3 correct or are the codes on page C-473 in the Three-Grade System (Nuclear Grade) for breast correct that requires conversion of the same examples to codes 2, 3, and 4 respectively? On page C-473: Delete the section titled "Three-Grade System (Nuclear Grade)" and delete the table. Use the tables on pages 94 and C-472 to code grade for breast cancer. This correction will be made in the next errata. 2005
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
20051134 Histology--Lymphoma: How is "histiomonocytic lymphoma" coded?

For cases diagnosed prior to 1/1/2010:Assign code 9755 [Histiocytic sarcoma; True histiocytic lymphoma]. "Histiomonocytic" is not standard terminology, according to our expert consultant. However, 9755 is the best code to assign.

For cases diagnosed 2010 forward, 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.

 2005
20051107 Chemotherapy/Radiation Therapy--Lymphoma: How is treatment coded when Rituxan is given in combination with the monoclonal antibody Zevalin conjugated to 90-Yttrium or the monoclonal antibody Bexxar conjugated to 131-Iodine in the treatment of NHL?

Code Rituxan as chemotherapy. Code 90-Yttrium as radioisotope. Code 131-Iodine as radioisotope when given with Rituxan as treatment for lymphoma.

Zevalin is a monoclonal antibody conjugated to Yttrium 90. Bexxar is a monoclonal antibody conjugated to Iodine 131. In both drugs, the monoclonal antibody is only the delivery agent for the radioisotope. Both drugs should be coded as radioisotopes. The one-two-three punch of Rituxan and zevalin followed by Rituxan and Bexxar should be coded as chemotherapy plus radioisotopes. Zevalin is also used by itself for people who have not responded to Rituxan.

 2005
20051030 CS Eval--All Sites: If any of the CS fields (TS/Extension, LN, or Mets) are based on the TNM and there is no text documenting the basis for the evaluation, are the evaluation fields coded to 0 instead of 1?

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 code 0 [No surgical resection done...based on physical exam...or other non-invasive clinical evidence] to the corresponding eval fields when CS Extension, Lymph Nodes or Mets at Diagnosis are coded based only on the TNM and no further information is available.

 2005
20051010 Primary Site/Priorities--Breast: When there are conflicting references to subsite in different reports, which report has priority? See Discussion. The clinical site of the palpable mass is outer quadrant. The pathologist states inflammatory breast cancer located in the central breast. Should the site be coded to C501 for central breast, C509 for inflammatory breast ca, or C508 for outer quadrant?

Code the breast subsite from the pathology report (C501, central).

The priority order for coding subsite from conflicting reports is

1. Pathology report

2. Operative report

3. Physical examination

4. Mammogram, ultrasound

The primary site of inflammatory breast carcinoma is coded to C509 when there is no palpable tumor.

 2005