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| Report | Question ID | Question | Discussion | Answer | Year |
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20110093 | Residence at dx: After living elsewhere (Florida) and traveling around the country in an RV with his spouse, is a patient a resident of this area for either primary if he was diagnosed with his first primary less than a month after arriving in the area and a second primary more than a year after parking his RV here? |
Use the patient's usual residence to determine residency. If the usual residence is not known or the information is not available, use the residence the patient specifies at the time of diagnosis. The SEER rules for determining "usual residence" match the rules used by the US Census Bureau. |
2011 | |
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20110005 | Histology--Heme & Lymphoid Neoplasms: How is the pre-2010 histology coded for a "follicular grade 2, non-Hodgkin lymphoma with marginal zone B-cell differentiation"? See Discussion. | This patient was seen in 2010 for the same primary as diagnosed in 2006. The histology was coded to marginal zone lymphoma [9699/3] in 2006. Is this correct? Or should this have been coded as a follicular lymphoma, ignoring the modifying expression "marginal zone B-cell differentiation"? | This is a 2006 diagnosis. The histology code is 9691/3 [follicular lymphoma, grade 2]. Do not code differentiation for hematopoietic cases.
For diagnoses 2010 and forward, a small number of cases of follicular lymphoma do have marginal zone differentiation. However, there is no code for this variant of follicular lymphoma. It would simply be coded as a follicular lymphoma because that is the most accurate histology code available. The marginal zone differentiation is not to be coded as a second primary (marginal zone lymphoma). |
2011 |
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20110062 | Histology--Heme & Lymphoid Neoplasms: Is diffuse large B-cell lymphoma, germinal cell type coded to diffuse large B-cell lymphoma? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph..
Per Rule PH30, use the Heme DB, determine the histology when rules PH1-PH29 do not apply. Code diffuse large B-cell lymphoma, germinal cell type to 9680/3 [diffuse large B-cell lymphoma (DLBCL)][9680/3]. Under the Alternate Names section of the Heme DB, these two terms are synonyms that share the same histology code.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 | |
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20110002 | Surgery of Primary Site--Penis: How is CO2 laser treatment coded for penile cancer? | Assign code 14 [laser] for CO2 laser treatment given for primary penile cancer. The CO2 is the method used to deliver the laser. | 2011 | |
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20110149 | Ambiguous Terminology/Histology--Heme & Lymphoid Neoplasms: How are the histology and diagnostic confirmation to be coded when the pathology report's final diagnosis is "plasma cell dyscrasia consistent with plasma cell myeloma" and the physician subsequently states this diagnosis was plasma cell myeloma? See Discussion. |
Pathologists often use the diagnosis "plasma cell dyscrasia" followed by an ambiguous term such as "consistent with" or "favors" with a more specific histology such as "plasma cell myeloma." Per initial training for Hematopoietic, ambiguous terminology is not used to code the histology for Heme & Lymphoid Neoplasms. Should the histology be coded as plasma cell dyscrasia (which is not found in the Heme DB or Manual) because the pathology report uses ambiguous terminology to describe the plasma cell myeloma? If the physician subsequently states the diagnosis is "plasma cell myeloma" in a note following the pathology, should the histology be coded as plasma cell myeloma based on that diagnosis as there was no ambiguous terminology used? How is the diagnostic confirmation coded for this case? Should this be a positive histology diagnosis (diagnostic confirmation code 1) if the pathology diagnosis uses ambiguous terminology only? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. The histology is coded as Plasma cell myeloma [9732/3]. The diagnostic confirmation is coded to 1 [positive histology]. Under the Definitive Diagnostic Methods section in the Heme DB it indicates that a bone marrow aspiration and bone marrow biopsy are procedures used to diagnose this disease process. This patient's diagnosis was based on the pathology (presumably from a bone marrow biopsy). NOTE: This is a reportable case. Ambiguous terminology is used to accession cases (determine reportability) because it has been used for over 30 years to do so. Any deviation from using ambiguous terminology to determine case reportability would cause the reporting of incidence counts to vary. In this case, there was a reportable, ambiguous terminology diagnosis of plasma cell myeloma on the pathology report; as well as a reportable physician's statement/diagnosis of plasma cell myeloma. Ambiguous terminology, however, is not used to report a more specific diagnosis for the Heme & Lymphoid neoplasms. For example, if the pathology report final diagnosis was "Myeloproliferative neoplasm, probably Polycythemia Vera" the histology would be coded as myeloproliferative neoplasm, unclassifiable [9975/3]. The ambiguous terminology indicates that the genetic testing, immunophenotyping, etc., probably are not complete or are not diagnostic of the more specific disease. Wait to code the histology until there is a definite diagnosis given. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 |
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20110020 | Heme & Lymphoid Neoplasms: How is cancer status to be coded when a patient diagnosed with MDS, undergoes treatment, but the MDS subsequently transforms to AML? | If the bone marrow no longer shows evidence of MDS, the cancer status for the MDS is disease-free. When cancer status is coded as disease-free (NED), it means that currently there is no clinical evidence of this disease (MDS). | 2011 | |
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20110127 | Primary Site--Brain and CNS: Are meninges surrounding cranial nerves cranial meninges [C700] or a part of the specific nerve's sheath? Is the primary site for an optic nerve sheath meningioma coded to optic nerve [C723] or cranial meninges [C700]? |
Code the primary site to cranial meninges [C700]. |
2011 | |
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20110074 | First course treatment/Date therapy initiated--Breast: How is the Date of Initiation of Hormone Therapy field coded when a patient undergoes "Tamoxifen blunting" to achieve better MRI imaging after a biopsy but prior to definitive surgery which is followed by adjuvant Tamoxifen therapy? See Discussion. | Patients are prescribed two weeks of "Tamoxifen blunting" to achieve better MRI imaging after biopsy confirmation of an ER/PR positive breast carcinoma. The Tamoxifen is subsequently discontinued and the patient has definitive surgery. Following surgery, maintenance Tamoxifen is initiated. Which date should be recorded for the Date of Initiation of Hormone Therapy field? Is it the first date when Tamoxifen blunting started or the post-surgical date when maintenance Tamoxifen is initiated? | Use the post-surgical start date of maintenance Tamoxifen to code the Date of Initiation of Hormone Therapy field. The actual hormone treatment begins after surgery when Tamoxifen blunting was performed. The low dose administered prior to surgery does not affect the cancer. | 2011 |
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20110079 | MP/H Rules/Histology: In the MP/H Manual, where is the documentation indicating "focal" is not a term that can be used to code histology? See Discussion. | Example: neuroendocrine carcinoma with focal squamous differentiation. | For the purposes of the MP/H rules, the term "focal" is not used to indicate a more specific histology. Terms that may be used to indicate a more specific histology are listed in the relevant histology rules. For example, see Breast histology rule H3. Notice the terms listed in the note for this rule are "type, subtype, predominantly, with features of, major, with ___ differentiation, architecture or pattern." The term "focal" is not included. This concept will be clarified in future revisions to MP/H rules. | 2011 |
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20110008 | MP/H Rules/Histology--Vulva: How is histology coded for VIN III with focal invasion? See Discussion. | Per SINQ 20000442, the histology for CIN III with microinvasion is coded to 8077 [squamous intraepithelial neoplasia, grade III] per the matrix system rules, with a behavior code of /3 [malignant]. Coding the histology to 8077/3 per the matrix principle causes IF25_3 and MorphICDO3_P1 edits to fail. Flagging the first error resolves any reporting issue. How is the MorphICDO3_P1 edit resolved? | Assign 8076/3 [squamous cell carcinoma, microinvasive] for VIN III with focal invasion. This applies to all terminologies listed under 8077/2. The SINQ question from 2000 will be retired. | 2011 |
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