| Report | Question ID | Question | Discussion | Answer | Year |
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20041063 | Primary Site/Histology (Pre-2007)--Mediastinum: How do we code these fields for a case described as a "neuroendocrine carcinoma" of the "anterior mediastinum" without failing the SEER "impossible" site/histology combination edit? See Discussion. | Two different facilities state that the patient has "neuroendocrine carcinoma of the anterior mediastinum." This coded combination failed SEER edit (SEERIF38). We can not correct it because that edit flag does not appear on our system. Both facilities indicate that the mediastinum is the primary. In addition, there is text to support both the histology and primary site codes. | For tumors diagnosed prior to 2007:
The combination of C381 [anterior mediastinum] and 8246 [neuroendocrine carcinoma] will be removed from the list of "impossible" site/histology combinations. There are rare cases of neuroendocrine carcinoma of the anterior mediastinum. As illustrated in the discussion, verify that the primary site is anterior mediastinum, the histology is neuroendocrine ca, and document those findings in the text.
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. |
2004 |
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20041067 | Histology (Pre-2007)--Lung: Does 8070 [squamous cell carcinoma], 8560 [adenosquamous carcinoma] or 8255 [adenocarcinoma with mixed subtypes] best represent this field for a lung biopsy described as a "poorly differentiated non-small cell carcinoma with squamous and glandular features with focal mucin positivity per mucin stain"? | For tumors diagnosed prior to 2007:
Assign code 8560/33 [Adenosquamous carcinoma, poorly differentiated]. "Glandular" carcinoma is a synonym for adenocarcinoma. Mixed adenocarcinoma and squamous carcinoma is coded to 8560. Do not use code 8255 [Adenocarcinoma with mixed subtypes] when a more specific complex code is available.
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. |
2004 | |
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20041031 | CS Extension--Bladder: How should this field be coded when the pathology states "papillary transitional cell carcinoma with no invasion into the submucosa or deep muscularis" but there is "focal extension of tumor into bladder diverticula"? | 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 the CS Extension field to 01 [Papillary transitional cell carcinoma stated to be noninvasive]. Extension into bladder diverticula does not change the code. Diverticula are pouches in the mucosa (mucous membrane). |
2004 | |
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20041043 | First Course Cancer-Directed Treatment--Bladder: How should Mitomycin-C instillation for bladder cancer be coded? | Code the instillation of Mitomycin-C into the bladder for a bladder primary in both the Chemotherapy and Surgery to Primary Site fields. Code the Chemotherapy field to 02 [Single-agent chemotherapy administered as first course therapy]. Mitomycin-C is listed in SEER book 8 as a chemotherapeutic drug, specifically an alkylating agent.
Also, code the Surgery of Primary Site field to 15 [intravesical therapy]. Code the surgical procedure as well as the type of drug (chemotherapy in this case). |
2004 | |
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20041055 | Primary Site/Grade, Differentiation, Cell indicator--Lymphoma: Will a Grade, Differentiation code of 6 [B-cell] for a lymphoma coded to primary site C80.9 [unknown] fail edits? See Discussion. | Patient had a large mass in chest wall that was excised and found to be large B cell lymphoma. Scans mentioned no involvement of lymph nodes but indicated nodules in the liver thought to be lymphoma as well. | For cases diagnosed prior to 1/1/2010:The combination of a primary site C809 with a Grade, Differentiation code of 6 when used for a lymphoma will not fail SEER edits. Avoid coding primary site to C809 when possible. Code primary site for the example above to C761 [Chest wall, NOS]. The chest wall is the only area of involvement, except for "liver nodules." Liver is an unlikely primary site for lymphoma. 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. |
2004 |
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20041047 | Multiple primaries (Pre-2007)/EOD-Extension--Fallopian Tube: How many primaries are coded when endometrioid adenocarcinoma involves bilateral fallopian tubes? See Discussion. | The pathologist states "because of the intimate association with the luminal line of the fallopian tube it is felt that this represents synchronous primaries rather than mets." The SEER Code Manual only lists ovary, retinoblastomas, and Wilms Tumors under the bilateral code stated to be a single primary. | For tumors diagnosed prior to 2007:
Complete two abstracts, one for left fallopian tube and one for right fallopian tube. This case has been determined to be two primaries by the pathologist. Bilateral involvement of paired sites (other than ovary, retinoblastoma and Wilms tumor) with the same histology within two months requires a determination of whether there are one or two primaries. The pathologist in the case above has made this determination.
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. |
2004 |
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20041022 | Primary site/Histology (Pre-2007)/Behavior: What is the correct site and histology/behavior for the following diagnosis: "mucinous cystadenoma of the appendix with perforation and pseudomyxoma peritonei." This was diagnosed at e-lap for a separate adenocarcinoma of the ascending colon. | For tumors diagnosed prior to 2007:
The appropriate code for mucinous cystadenoma of the appendix with perforation and pseudomyxoma peritonei is C18.1 8470/0. It is not reportable to SEER. According to our pathologist consultant, mucinous cystadenoma is a legitimate term for such appendiceal tumors. They may implant all over the peritoneum as pseudomyxoma peritonei, especially in the face of perforation, without being histologically malignant.
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. |
2004 | |
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20041021 | Histology (Pre-2007)--Corpus Uteri: How should this field be coded when the D&C which shows "adenocarcinoma with mucinous and papillary features" and the TAH demonstrates only "endometroid carcinoma"? See Discussion. | Should Histology be coded to 8380 [endometroid adenocarcinoma] because it is the most representative sample or to 8323 [mixed cell adenocarcinoma], per the Complex Morphology Coding Guidelines? The instructions in the Guidelines seem to imply that it is most important to represent combination histologies first, with majority (most representative sample) of tumor having a lower priority. | For tumors diagnosed prior to 2007:
Code Histology based on the pathology report from the most representative tissue. For the example above, code Histology to 8380 [Endometroid adenocarcinoma] based on the TAH/BSO pathology report.
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. |
2004 |
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20041042 | Multiple Primaries (Pre-2007)/Histology (Pre-2007)--Kidney: How many primaries, with what histology(ies) should be coded when nephrectomy pathology specimen shows separate tumors of "renal cell carcinoma [clear cell type]" and "renal cell carcinoma [granular cell type]"? | For tumors diagnosed prior to 2007:
Abstract two primaries. This is an example of two tumors with different histologic types in the same site. The right kidney has two separate tumors.
8310/3 [renal cell carcinoma (clear cell type)] 8320/3 [renal cell carcinoma (granular cell type)]
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. |
2004 | |
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20041099 | First Course Treatment: If a patient makes a blanket refusal of all recommended therapy or refuses all treatment before any therapy was recommended, are only immunotherapy and hematologic/endocrine therapies to be coded as refused (code 87)? Or should all treatment modalities be coded as refused if a patient makes a blanket refusal? Or should none of the treatment modalities be coded as refused because we do not know what would have been recommended? See Discussion. | Coding instructions for immunotherapy and for hematologic/endocrine procedures state that Code 87 is to be assigned if either of the following circumstances apply: 1) If the patient made a blanket refusal of all recommended treatment. 2) If the patient refused all treatment before any was recommended. These instructions are not included for other treatment modalities. | When the patient refuses treatment, the first course of therapy is no treatment. Code all treatments as refused. | 2004 |
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