Primary Site--Head & Neck: How is this field coded for a tongue primary described as "located on the lateral" or "left oral" tongue? See Discussion.
Case 1. Patient with squamous cell carcinoma, left oral tongue.
Case 2. Squamous cell carcinoma, left lateral tongue.
Case 3. Patient status post biopsy of lesion on tongue. Exam: healing left lateral tongue incision with sutures in place in underside of tongue.
Code Primary Site for cases 1 and 2 above to C023 [Anterior 2/3 of tongue, NOS]. Code lateral tongue without mention of dorsal or ventral surface to C023 [Anterior 2/3 of tongue, NOS].
Code Primary Site for case 3 to C022 [Ventral surface of tongue]. The underside of the tongue is specified as the site of the biopsy in case 3.
CS Extension--Head of Pancreas: What code is used to represent extension to the superior mesenteric artery? See Discussion.
In the CS coding scheme for Head of Pancreas, superior mesenteric artery is listed under both code 54 (T3) and 60 (T4).
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.
Assign code 60 for a primary in the head of the pancreas extending to the superior mesenteric artery. CS Extension code 54 should be Superior mesenteric VEIN and code 60 should be Superior mesenteric ARTERY. An errata will be issued by CS. In addition, extension 54 indicates resectable disease and code 60 is not resectable.
Multiple Primaries (Pre-2007)/Date of Diagnosis--Bladder: How is date of diagnosis coded when metastases consistent with a bladder primary are found more than a year after a diagnosis of non-invasive bladder cancer? See Description.
A non-invasive papillary transitional cell carcinoma is removed by TURB in May 2002. In January 2003, a bone biopsy reveals metastatic transitional cell carcinoma consistent with bladder primary.
For tumors diagnosed prior to 2007:
Code a second bladder primary diagnosed in January 2003.
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.
First Course Treatment/Immunotherapy--Colon: Can "Sandostatin" be coded for treatment of carcinoid tumors of the colon because it flushes tumor cells from the colon in addition to controlling diarrhea?
Do not code Sandostatin (Ocreotide Acetate) as treatment. This is an ancillary drug used to treat symptoms of diarrhea. SEER Book 8 is undergoing revision and will include this change.
Immunotherapy/Chemotherapy: Are monoclonal antibodies, such as Avastin and Erbitux, coded as immunotherapy or chemotherapy? See Discussion.
In review of the "FDA-approved oncology agents not listed in SEER Book 8" provided in 5/02, it appears "monoclonal antibodies" are coded as immunotherapy.
Code Avastin and Erbitux as chemotherapy because both of these drugs are growth inhibitors. Code growth inhibitors (cytostatic agents) as chemotherapy. Do not assume that monoclonal antibodies are coded as immunotherapy.
Reportability/Date of Diagnosis--Ovary: Is a patient SEER reportable in 2001 or 2003 if she presented with a diagnosis of papillary serous tumor of low malignant potential [borderline tumor] per the 5/2001 surgery but at the time of the planned second look laparoscopic surgery is stated to have Stage 3A ovarian cancer? See Discussion.
A patient was seen in 5/2001 for large pelvic mass growing from right ovary. After TAH and USO and partial omemtectomy, path diagnosis was papillary serous tumor of low malignant potential (borderline tumor), unruptured. Right ovary and omental implant have identical histologic appearance, except the psammoma body formation and the ovary does not.
Patient does not return for lap as planned in 6-12 months.
In 1/03 she returns to hospital with abdominal pain and has debulking, hemicolectomy and Hartmann's procedure. 1/03 Path report "metastatic papillary serous adenoca." Chart now says "History of stage 3A ovarian cancer."
Yes, this case is reportable in 2003. Malignancy was confirmed in 2003. The diagnosis made in 2001 is not reportable for that year, and was not reviewed or revised according to the information provided.
CS Site Specific Factor 4--Prostate: If PAP is not mentioned in the chart, should Site Specific Factor 4 be coded to 999 [unknown or no information] or 000 [test not done]?
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.For tumors diagnosed 2004 only:
Code the CS Site Specific Factor 4 to 999 [Unknown or no information; Not documented in patient record]. If there is no report of a lab test in the health record, code as 999.
Code this field to 000 [Test not done] when there is a statement in the record that a test was not performed.
Tumors diagnosed 1/1/2005 forward no longer have PAP coded in the Site Specific Factor 4 field.
CS Extension/Histology (Pre-2007)--Breast: Paget disease with underlying DCIS. How should CS Extension, SEER Summary Stage 2000, histology, and behavior be coded?
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.
For tumors diagnosed prior to 2007:
Based only on the information provided above,
1. The CS extension code is 07 [Paget disease of nipple (without underlying invasive carcinoma pathologically)].
2. The SS 2000 stage is 1 [Localized].
3. The histology code is 8543 [Paget disease and intraductal carcinoma of breast]. The behavior code is 3 [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.
CS Extension/EOD Extension--Renal Pelvis: Primary site is renal pelvis with direct extension to the rt adrenal gland. What is the correct extension code?
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.
Assign CS Extension code 67 [Adrenal gland from renal pelvis] for adrenal extension from renal pelvis -- T4 and regional direct extension.
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.
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.