Multiple Primaries (Pre-2007)--Thyroid: Would a papillary carcinoma of the right lobe of the thyroid diagnosed approximately 2 1/2 years after a papillary carcinoma of the left lobe be coded as a second primary? See Description.
8/31/1999: papillary carcinoma, left lobe thyroid, treated with lobectomy.
1/17/2002: papillary carcinoma, right lobe, treated with lobectomy, completion thyroidectomy.
For tumors diagnosed prior to 2007:
Yes, this is a second primary. The second papillary carcinoma was more than 2 months after the first and not specified as recurrent or metastatic.
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.
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.
Laterality--Head & Neck: Does the site code C098 need a laterality code? See Description.
In the SEER EOD-88 3rd edition, page 36, site code C098 does not need laterality. In the SEER Program code manual, 3rd edition, page 93, site code C098 is listed as a site that needs a laterality code 1-9.
Topography code C098 [Overlapping lesion of tonsil] requires a laterality code of 1-9. Follow the laterality guidelines in the SEER Program Code Manual.
Reportability/Histology--Hematopoietic, NOS: Does the presence of sideroblasts on a bone marrow biopsy confirm a diagnosis of refractory anemia with sideroblasts?
Final path diagnosis of bone marrow biopsy:
I. Hypercellular marrow for age with trilinear hyperplasia.
II. Decreased iron stores with decreased sideroblasts.
Comment: Although the overall picture is not diagnostic of a specific entity, it is most consistent with an early stage myelodysplastic syndrome which would best be considered refractory anemia at this point.
In this case the percentage of sideroblasts is not stated. Would the path diagnosis of "decreased sideroblasts" along with the path comment of "refractory anemia" indicate that this case should be coded to 9982/3 [Refractory anemia with sideroblasts]?
For cases diagnosed prior to 1/1/2010:
For the hematologic diseases, do not accession the case unless there is a definite positive diagnosis. A positive diagnosis, such as "Refractory anemia" must be stated in order to code that diagnosis. Other words associated with the positive diagnosis, such as "sideroblasts" are NOT to be used alone to assume a diagnosis.
Decreased sideroblasts does not make a diagnosis of Refractory anemia with sideroblasts. The sideroblasts for 9982/3 [Refractory anemia with sideroblasts] are characteristic in rings, and are INCREASED to make the diagnosis.
Based on the information provided, this case is not reportable. The final path diagnosis is not a reportable disease. The comment further states that the overall picture is not diagnostic of a specific entity. Therefore, it should not be reported at this point.
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.
EOD-Extension--Colon: How is this field coded for an appendical primary when the appendix has ruptured and intrapentoneal fluid is positive?
For cases diagnosed 1998-2003: Code EOD extension as 85 [Metastasis]. Positive intraperitoneal fluid is equivalent to distant metastasis (implantation) for colon, including appendix, primaries.
Grade, Differentiation--Bladder: How is this field coded for a five grade system? See Description.
Example: Invasive, high grade transitional cell carcinoma (Grade 4-5/5)
For this example, code grade as 4 based on the term "High grade." If "high grade" was not stated, the grade would be coded as 9, not determined. There is no SEER translation between the ICD-O grades and a five grade system for bladder. None of the pathololgist experts we querried knew of a five grade system for bladder.
Ambiguous terminology/EOD-Extension: Is the term "within" a term of involvement in coding extent of disease? See Description.
For example: a kidney tumor is described as "completely encased within the renal capsule with no extension into perirenal fat." Does this mean the renal capsule has been invaded (extension code 20) or that the tumor is totally contained within an area surrounded by the renal capsule (extension code 10)?
For cases diagnosed 1998-2003: The term "within" is not one of the listed ambiguous terms for EOD. Determine extent of involvement from the context in which "within" appears.
In the example, "Encased" is an ambiguous term meaning not involved. Code extension for the example to 10 [Invasive cancer confined to kidney cortex and/or medulla].
Diagnostic Confirmation--Hematopoietic, NOS: Is a multiple myeloma diagnosed by an FNA of the lumbar spine (or any other non-bone marrow location) a diagnostic confirmation 1 or 2? See Description.
Does the rule on page 111 of the SEER Program Coding Manual, 3rd Edition, for code 1 apply to myelomas (in the same way it applies to leukemias)?
Assign code 1 [Positive histology] for aspiration of bone marrow. This rule is not limited to leukemias.
First Course Treatment--Thyroid: Is hormone replacement following total thyroidectomy coded as first course treatment for all thyroid cases?
Code Hormone therapy as 01 [Hormone therapy administered as first course therapy] when thyroid replacement therapy is part of the first course of treatment for follicular or papillary thyroid cancer following thyroidectomy.
Thyroid hormone replacement therapy has a treatment effect on differentiated (follicular and papillary) carcinomas of the thyroid. This treatment effect is not seen for most medullary and undifferentiated thyroid cancers.
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