| Report | Question ID | Question | Discussion | Answer | Year |
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20020011 | Histology (Pre-2007): What code should be assigned to acinar adenocarcinoma and ductal adenocarcinoma? | For tumors diagnosed prior to 2007:
Assign code 8255 [Adenocarcinoma with mixed subtypes]. According to histology rule #4 for a single tumor on page 86 of the 2004 SEER manual, use a combination code if one exists.
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. |
2002 | |
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20021106 | Histology (Pre-2007)/Diagnostic Confirmation: What code is used to represent the histology that initially presents on uterine curettage as a hydatidiform mole and after pulmonary metastases develop a month later, the clinical diagnosis is "metastatic gestational trophoblastic disease"? | For tumors diagnosed prior to 2007:
Code the Histology field to 9100/3 [Choriocarcinoma]. Gestational trophoblastic neoplasia includes the diagnosis of choriocarcinoma.
Code the Diagnostic Confirmation field to 8 [Clinical diagnosis only] based on the information above. However, if imaging, direct visualization, or another method identified the pulmonary metastases, then code the Diagnostic Confirmation accordingly.
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. |
2002 | |
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20021111 | Histology/Grade, Differentiation--Lymphoma/Leukemia: Do you agree with coding a diagnosis of Nasal NK/T cell lymphoma to 9719/38? | For cases diagnosed prior to 1/1/2010:Yes. Code the Grade, Differentiation field to 8 [NK cell] rather than 5 [T-cell]. Code the Histologic Type to 9719/38 [NK/T-cell lymphoma, nasal and nasal-type with Cell indicator of NK (8)]. 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. |
2002 | |
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20021026 | Surgery of Primary Site--Skin: Should Mohs surgery be code to 27 [Excisional biopsy] or 31 [Shave biopsy followed by a gross excision of the lesion]? See discussion. | Under surgery coding in the 5/22/01 SEER Abstractor/Coder Workshop book, page 20, it states that Mohs surgery should be coded as an excisional biopsy. The ACoS I&R dated 6/6/2001 states that it should be coded to 31. | For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 34 [Mohs surgery, NOS], 35 [Mohs with 1-cm margin or less] or 36 [Mohs with more than 1-cm margin]. | 2002 |
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20031056 | Multiple Primaries (Pre-2007)--Breast: For a patient with a remote history of lobular breast carcinoma, would a new diagnosis of lobular breast carcinoma with DCIS be a new primary, even though the physician designates it as recurrent? See Description. |
A history of right breast lobular ca in 1991 treated with a partial mastectomy. Diagnosed 3/02 with "recurrent right breast ca" per physician; pathology in 2002 is lobular and DCIS. Would the DCIS make this a new primary regardless of the physician's designation of 'recurrent' or is this the same primary? |
For tumors diagnosed prior to 2007: Accession as two breast primaries -- the first lobular ca in 1991; the second lobular and DCIS in 2002. The differing histologies and the length of time between them negate the physician's designation as "recurrent" in this case. 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. |
2003 |
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20031036 | Histology--Hematopoietic, NOS: When both the path and clinical diagnoses simultaneously reflect reportable diagnoses but one is a worse form of the same disease process, which diagnosis do we code? See Description. | Would this case be coded to RAEB or AML? Bone marrow diagnosis: Hypercellular marrow with profound trilinieage dyspoietic changes. Comment: the features are consistent with RAEB. Clinical diagnosis five days later states: Myelodysplastic syndrome, early acute myelocytic leukemia (likely AML). | For cases diagnosed prior to 1/1/2010:When several diagnoses are made as part of the diagnostic process within two months, code the one with the worst prognosis. Code the case example as acute myelocytic leukemia. 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. |
2003 |
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20031113 | Primary site/Surgery of Primary Site/Surgical Procedure of Other Site--Unknown & ill-defined site: How are these fields coded for this type of primary site when a tumor excision and lymph node dissection is performed? See Description. | Patient had a left parotidectomy w/ neck dissection in 02/2003. Findings showed a 10x5cm neck mass over the angle of the mandible as well as a 1.5 cm level 4 mass. Path showed invasive mod diff squamous cell ca. with posterior soft tissue margin positive for tumor; small portion of salivary gland had no tumor. Metastatic SCCa in 5 of 34 lymph nodes of neck dissection; no tumor in parotid lymph nodes. Pathology report says this could be a parotid carcinoma because the bulk of the disease is in the parotid, but it could also be metastatic...correlate with clinical findings. Doctor calls this unknown primary of the head and neck. Is this C80.9 or C76.0? | For cases diagnosed 1998-2003: The data item "Surgery of Primary Site" is intended to record only surgeries of the primary site. If the primary site is unknown or ill-defined, it is impossible to determine whether or not a particular surgery was performed on the primary site. "Surgical Procedure of Other Site" collects much less specific information; however, this is the correct data item to record surgery performed when the primary site is unknown or ill-defined. For the case example, code the primary site as C76.0 [Head, face or neck, NOS]. Code Surgery of Primary Site as 98 [All unknown and ill-defined disease sites, with or without surgical treatment]. Code Surgical Procedure of Other Site as 1 [Non-primary surgical procedure performed]. |
2003 |
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20031008 | Histology (Pre-2007)--Kidney: Is 8316/3 [Cyst associated renal cell carcinoma] the appropriate code for 1) Cystic renal cell carcinoma, 2) Renal cell carcinoma mass with cystic areas and 3) Cystic renal cell carcinoma, clear cell type? | For tumors diagnosed prior to 2007:
Yes, ICD-O-3 histology code 8316 is the correct code for the three examples above. There are two categories of cyst-associated renal cell carcinomas: Renal cell carcinoma originating in a cyst, and Cystic renal cell carcinoma.
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. |
2003 | |
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20031153 | Laterality/Multiple Primaries (Pre-2007)--Ovary: Are ovarian primaries with bilateral involvement always coded to laterality 4 (bilateral)? See Description. | Example: "Right ovary with mass replacing majority of ovarian tissue consistent with serous adenoca. Lt ovary with foci of adenoca." No specific statement of primary. Can we assume that the malignancy originated in the right ovary since it is more extensively involved or should laterality be coded 4 because both ovaries have tumor? | For tumors diagnosed prior to 2007:
If one ovary is listed as the primary site, code laterality to that ovary. The example above is one of those times when you would code to the single ovary. The issue of one or both ovaries being involved is handled in staging.
Abstract the example above as a single primary with code 1 [Right] for laterality.
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. |
2003 |
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20031026 | EOD-Extension--Head & Neck: If there is no mention of vocal cord mobility, do we code indicating normal vocal cord mobility or do we code EOD-Extension to a "localized, NOS?" See discussion. | How do we code EOD-extension for the following tumor of the supraglottic larynx? Limited stage small cell cancer of epiglottis per discharge signout. Physical exam revealed swelling of anterior aspect of epiglottis and narrowing of epiglottis. Neck without palpable masses. Laryngoscopy with biopsy and esophagoscopy showed extensive tumor involving entire laryngeal surface of epiglottis, extending onto aryepiglottic fold, onto false vocal cords and onto left true vocal cord. Ventricle on left side was obliterated with tumor. Right true vocal cord free of tumor. There is no information regarding vocal cord mobility. Biopsy of the left true vocal cord was negative. Should EOD-extension be coded to 20 [Tumor involves more than one subsite of supraglottis without fixation or NOS] or 50 [Localized NOS]? | For cases diagnosed 1998-2003, if vocal cord mobility is not mentioned, code as normal mobility. Code EOD-extension for the example case as 20 [Tumor involves more than one subsite of supraglottis without fixation or NOS]. | 2003 |
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