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Report Produced: 02/17/2026 03:50 AM

Report Question ID Question Discussion Answer Year
20081067 CS Extension--Lymphoma: When does the coding change take effect that is referred to in SEER edit IF195, that states localized lymphoma in primary sites C024, C090-099, C111, C142, C172, C181, and C379 must be coded to CS extension 10, and cannot be coded to extension 11? See Discussion. CS version 1.04 does have a new note 1 in the lymphoma scheme that appears this coding change. In the past, we used code 11 with these sites for localized lymphoma and SINQ 20061088 confirms this line of thinking.

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.

This change was made with the release of CS version 01.04.00 on October 31, 2007. The rules went into effect for cases diagnosed January 1, 2008 and later. A note was added to SINQ 20061088 stating that the answer pertains to cases diagnosed prior to January 1, 2008.

 2008
20081088 CS Lymph Nodes/CS Mets at Dx: How should these fields be coded for an in situ diagnosis when the patient was diagnosed by biopsy only and there is no information in the chart regarding an evaluation of lymph nodes or metastatic sites? See Discussion.

In reference to the case below, does it make a difference if the CS T stage is known based on the primary excision but there is no clinical information in the record regarding the nodes or metastasis evaluation.

This scenario is seen on outpatient records of breast biopsies and melanoma excisions; i.e., punch bx followed by gross excision of the lesion but the medical record contains no clinical information or statement of everything else normal.

I&R Question 17625 2/16/2006

A patient was diagnosed with ductal carcinoma in situ by needle core biopsy of the right breast. There was no further information in the chart stating if or where the patient went for staging work-up and treatment. What are the codes for CS Extension, CS Regional Lymph Nodes and CS Distant Mets at Dx?

I&R Answer: Sufficient tissue must be taken to determine the T category. If this is the case, CS Extension = 00.

Unless the physician makes the statement that the physical exam is negative, code the CS Regional Lymph Nodes = 99 CS Distant Mets at DX = 99.

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 and CS Mets at Dx 00 [None] for an in situ diagnosis with no other information.

The CS instructions state that CS LN's should be coded 00 for in situ because in situ by definition is non-invasive. The same logic applies to CS mets in the case of in situ. The I&R answer will be revised.

 2008
20081132 MP/H Rules--Breast: What is the histology code for a breast tumor that is ductal ca with focal squamous differentiation? See Discussion. SINQ 20021062 states for cases Dx'd prior to 2007, use 8570. Is 8570 also used when the squamous differentiation is focal? For cases diagnosed 2007 or later, use rule H14 and code the histology 8500 [duct carcinoma]. Ignore histologies described as "focal," "focus," or "foci." This instruction will be added to the histology rules in the upcoming revision of the MP/H manual. 2008
20081079 Ambiguous terminology/Reportability--Kidney: Is a case reportable if a biopsy diagnosis of "suggestive of oncocytoma, malignant neoplasm cannot be excluded" follows a CT scan that was read as "suspicious for carcinoma"? See Discussion. Pt is nursing home resident. CT abdomen/pelvis shows a "mass in the right kidney, highly suspicious for renal cell carcinoma". CT-guided needle biopsy performed with final diagnosis: "Neoplasm suggestive of oncocytoma. A malignant neoplasm cannot be excluded." No other information is available. This case is not reportable based on the information provided. The suspicious CT finding was biopsied and not proven to be malignant. "Suggestive of" is not a reportable ambiguous term. 2008
20081016

Laterality--Brain and CNS: When a meningioma extends to both right and left sides, is laterality coded 4 for bilateral or 9 for midline? See Discussion.

Operative Findings: Bilateral frontal craniotomies for excision of giant meningioma which extended onto optic chiasm.

Path: Bifrontal tumor, 6.5 cm meningotheliomatous meningioma.

 If it is not possible to determine whether the meningioma originated on the left or the right, assign code 4 [Bilateral involvement, lateral origin unknown; stated to be single primary]. 2008
20081023 Histology: Must every word in the ICD-O-3 code definition appear in the diagnosis in order to assign that ICD-O-3 code? See Discussion. Is the diagnosis "Acute myeloid leukemia, M2" coded to Acute myeloid leukemia with maturation, FAB M2, NOS, (9874/3) or to Acute myeloid leukemia, NOS, (9861/3)?

For cases diagnosed prior to 1/1/2010:The general instructions for assigning histology codes are to code as precisely as possible. Acute myeloid leukemia with maturation is the definition of the FAB M2 category. A pathologist does not need to provide every word in the term associated with an ICD-O code; pathologists don't always talk that way. AML M2 is a very specific diagnosis and should be coded to 9874/3.

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.

2008
20081039 Diagnostic Confirmation/Histology--Hematopoietic: How are these fields coded when the final pathologic diagnosis for a bone marrow biopsy differs from the final clinical diagnosis of a hematopoietic disease? See Discussion.

Frequently, pathology reports describe hematopoietic diseases using ambiguous terms. Flow cytology and cytogenetics may be obtained. It appears that the clinician is the person who pulls all the information together for a diagnosis.

Example: Bone marrow biopsy is most compatible with chronic phase myeloproliferative disease. Path comment: Differential would include CML. Outside hematology report indicates an elevated peripheral WBC, primarily neutrophils. Flow cytometry showed 1.0 % of the white cells are myeloid blasts of abnormal phenotype, additionally finding 7.3 % basophils. Flow reported peripheral blasts at 1.2 % and peripheral basophilia. Cytogenetics report showed abnormality with trisomy of chromosomes 13 and 21. This finding is consistent with a clonal abnormality suggestive of acquired disease. Results were consistent with the absence of the t(9,22)(q34;q11) translocation or fusion product associated with CML. Subsequent clinical impression: Bone marrow evaluation most consistent with CML. Overall features most consistent with CML.

For cases diagnosed prior to 1/1/2010:Code the Diagnostic Confirmation field as 1 [positive histology]. Code the ICD-O-3 morphology based on the clinician's statement.

The code in Diagnostic Confirmation pertains to the best method used to confirm the presence of cancer over the entire course of the disease. Therefore, if a bone marrow report confirms cancer, code 1 [positive histology] in Diagnostic Confirmation.

Code the histology using all of the information available. The clinician has access to all of the information relating to this case. The pathologist had only the bone marrow. Code the histology recorded by the clinician.

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.

 2008
20081118 Surgery of Primary Site--Brain and CNS: How is this field to be coded when a patient undergoes stereotactic biopsy of a brain tumor? Path specimen consists of four fragments of tissue measuring .7, .6 and .3 cm. Assign code 20 [Local excision (biopsy) of lesion or mass. Specimen sent to pathology from surgical event 20]. 2008
20081097 DCO/Systemic Treatment, Surgery Sequence: How does SEER want systemic treatment/surgery sequence coded for a DCO case?

Assign code 0 [No systemic therapy and/or surgical

treatment] as a default for DCO cases.

 2008
20081138 MP/H Rules/Histology--Lung: What is the correct histology code for a neuroendocrine neoplasm described as a carcinoid and also referred to as oncocytic? See Discussion.

Left mainstem bronchus mass excised: metaplastic endobronchial mucosa with submucosa containing an infiltrating poorly diff malignant tumor. Origin of tumor is not identified in overlying mucosa. IHC stains will be performed.

Addendum #1. IHC stains show well diff neuroendocrine neoplasm, favor carcinoid. Recommend sending this to expert in lung neoplastic pathologist.

Addendum #2. (lung path specialist) oncocytic neuroendocrine neoplasm.

Is this 8246 or 8290 or something else?

 For cases diagnosed 2007 or later, code as 8246 [Neuroendocrine carcinoma, NOS]. According to our pathologist consultant, the neuroendocrine description is more specific than the oncocytic description in this case. 2008