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For cases diagnosed 1/1/2003 and after:

1. Code hormone therapy to 01. Code any therapy administered to treat cancer tissue that achieves its effect on cancer tissue through a change in the hormone balance in the hormone therapy field. Decadron is coded for leukemias, lymphomas and multiple myelomas primaries. It is coded for other sites only when stated to be cancer-directed treatment.

2. Code hormone therapy to 01. Decadron should be coded as hormone therapy for multiple myeloma when given alone or as part of a first course of treatment chemotherapy regimen.

For tumors diagnosed prior to 2007:

Code the Histology field to 8570/3 [Adenocarcinoma with squamous metaplasia]. Our pathology consultant agrees that squamous metaplasia is synonymous with squamous differentiation.

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.

The case is reportable if a pathologist or clinician confirms a diagnosis of cancer. If there is no such confirmation, the case is not SEER reportable.

For cases diagnosed 2001-2006:

Borderline tumors are not reportable to SEER as of 2001. If you are collecting them in your registry, use the following procedure: Exception 1 in the SEER Program Code Manual, 3rd Edition, responds to the issue of processing ovarian tumors. Simultaneously occurring ovarian tumors with a single histology are coded as one primary. In the case you cite, the right ovary primary occurred 7 months after the left ovary primary. This is not simultaneous, so it would be counted as a second primary.

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.

For cases diagnosed 1998-2003:

Using the EOD scheme for lymphoma, code the Extension field to 11 [Localized involvement of a single extralymphatic organ or site; Stage IE] for all 3 of these cases.

For the stomach lymphoma: There are 2 areas of lymphoma, but it is still confined to one site.

For the other 2 lymphomas: Intraluminal (mucosal) spread of the lymphoma never equals extension. The same phrase that was added to code 21, "Direct extension to adjacent organs or tissues", will be added to code 11 in the Collaborative Stage System. Neither "mucosal spread to a contiguous organ" or "direct extension into a nearby organ" affect staging. Both are still coded to 11 as long as there are no other sites of lymphoma involvement.

EOD code 80 is poorly written. It does not mean diffuse invovement or multiple tumors in a single organ but rather "diffuse disease in two or more organs."

For tumors diagnosed prior to 2007:

Code the Histology field to the majority of the tumor, which is 8140/3 [adenocarcinoma, NOS]. The terms "areas of" and "foci of" should be ignored because they are not terms that reflect the majority of the tumor. Therefore, we cannot use rule A on page 2 of Coding Complex Morphologic Diagnoses because this diagnosis does not represent a complex morphology.

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.

Code "embolization" (or hepatic artery embolization, HAE) to a metastatic site in Surgical procedure of Other Site. Assign code 1 [nonprimary surgical procedure performed].

This procedure was previously coded as other therapy, experimental. Code as surgery as of July 2005.

For cases diagnosed 1998-2003:

Code the EOD-Size of Primary Tumor field as stated by the pathologist in the final pathologic diagnosis. If the size of the tumor is the same as the size of the polyp, assume the polyp was completely replaced by tumor.

For cases diagnosed 1998-2003:

Code the EOD-Extension field to 14 [invasive and in situ components present, size of entire tumor coded in Tumor Size AND in situ described as minimal (less than 25%)]. The pathologist did not use a code as defined by SEER. For cases described as "less than or equal to 25%", choose the lower of the two EOD code choices.

For tumors diagnosed prior to 2007:

Code the Histology field for the first example to 8140/2 [Adenocarcinoma, NOS, in situ] and for the second example to 8077/2 [AIN, grade III]. For both of the cases code the Grade, Differentiation field to 9 [Cell type not determined not stated or not applicable]. The 6th digit (grade code) of ICD-O-3 describes how much or how little a malignant tumor resembles the normal tissue from which it arose. In contrast, "grade" is used in the examples above to describe the degree of dysplasia, from mild dysplasia (low grade) to severe dysplasia (high grade). Do not record the degree of dysplasia in the 6th digit grade field.

For tumors diagnosed 2007 or later, refer to the MP/H rules for histology coding instructions. 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.