Report | Question ID | Question | Discussion | Answer | Year |
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20041033 | Histology--Hematopoietic, NOS: When the histology is described in both WHO and FAB terms, which terminology has priority to code this field? See Discussion. |
Example: Bone marrow biopsy was reported as: "Markedly hypercellular marrow aspirate with myelodysplastic alterations morphologically consistent with refractory anemia (FAB) or refractory cytopenia with multilineage dysplasia (WHO)." | For cases diagnosed prior to 1/1/2010:Give preference to the WHO terminology when both are used in the final pathology diagnosis. The WHO classification of tumors is the current standard and is recommended by the College of American Pathologists. 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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20041095 | Primary site: How is this field coded for a malignancy described as a "intracranial squamous cell carcinoma (8070) arising in a previous epidermoid cyst"? See Discussion. | 4-5-02 MRI Brain: Enhancing mass is probably a recurrence of the original tumor resected in 1983 (benign). 4-8-02 Gross resection. Lesion was coming up against her brain stem: Removed it grossly. Path: 4-8-02 Brain tumor, left temporal: SCC arising from a previous epidermoid cyst of the brain. XRT began 4-25-02. Path states: "Squamous lesions suspicious for malignant transformation of old epidermal cyst (1983). It has been reported in literature that epidermoid cysts in the brain can undergo a malignant transformation which is what happened in this case." It appears the patient has an intracranial epidermoid cyst that is now giving rise to SCC. Squamous cell carcinoma (8070) of the brain (C71_) fails the edit Primary Site, Morphology-Imposs ICDO3 (SEER IF38). |
Code the primary site to C760 [Ill-defined site; Head, face or neck, NOS]. There is an intracranial malignancy arising from a previously resected epidermoid cyst. Squamous cell carcinoma, primary of the brain, is a non-overridable edit error. | 2004 |
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20041071 | Histology (Pre-2007)--Breast: When the histology from a lumpectomy differs from that of a core needle biopsy, should the lumpectomy histology be coded? See Discussion. | Histology - Page 85 of the SPM 2004, Histology Type Coding Instructions, #2. Use the histology stated in the final diagnosis from the pathology report. Use the pathology from the procedure that resected the majority of the primary tumor. Based on this rule, should the following case should be coded to Ductal Carcinoma (8500/31)? Core needle bx: WD Infiltrating Ductal Carcinoma with focal lobular features. Lumpectomy: WD Invasive Ductal Carcinoma. |
For tumors diagnosed prior to 2007:
Yes, code this case to 8500/31 [Well differentiated invasive ductal carcinoma]. Code the histology stated on the pathology report from the procedure removing the most tumor tissue. A lumpectomy will usually provide more tumor tissue than a core needle biopsy. First, determine which specimen contains the most TUMOR tissue -- in this case the lumpectomy. Next, apply the histology coding rules to the diagnosis on that pathology report. The rationale is that a diagnosis from a smaller specimen will be less accurate and less representative of the true histology compared to a larger tumor specimen.
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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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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20041094 | 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. |
2004 | |
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20041016 | 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. |
2004 | |
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20041079 | CS Mets at Dx/CS Mets Eval--Colon: Would the metastasis field be coded to 00 [No; none] and the evaluation field be coded to 1 [No path exam of metastatic tissue performed.] when the source of information is from the operative findings for the following 6 different cases? 1) Liver normal; 2) No evidence of metastatic disease; mesentery normal, 3) Small ascites; no liver metastasis, mass adherent to duodenum without obvious invasion, 4) No mets or local invasion, 5) No evidence of carcinomatosis, peritoneal studding or malignant effusion and 6) Tumor adherent to lateral sidewall (path negative); no evidence of metastatic implants. | 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. The CS Mets Eval code refers to the method used to evaluate the site farthest from the primary site. The correct code may not be the highest eval code. For example 1 above, if the liver is the site farthest from the colon primary that was evaluated for distant mets, code the CS Mets Eval code to the method used to evaluate liver. Code surgical evaluation as 1. Assuming this is all of the information about possible distant metastatic sites for the examples above, code CS Mets at DX as 00, and CS Mets Eval as 1 for each. Please note: imaging of farther sites should also be included when CS Mets at DX is coded. For example, if there was also a negative chest X-ray, the CS Mets at DX field would be 00 but the CS Mets Eval field would be 0 because the CXR documents that there are no mets beyond the immediate area of the tumor. |
2004 | |
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20041026 | CS Tumor Size--Ovary: The size of a cyst is not coded in this field. However, can the size of a "cystic mass" be coded in this field? See Discussion. | The specimen consists of a cystic mass which weighs 1520 grams and measures 23 x 17 x 10 cm. | If the tumor is described as a "cystic mass" and only the size of the entire mass is given, code the size of the entire mass, because the cysts are part of the tumor itself.
Please note: Ovarian cancer stage is not based on tumor size. |
2004 |
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20041060 | Reportability/Behavior Code--Melanoma: If a dermatologist states a "proliferation of atypical melanocytes confined to epidermis" is melanoma in situ, is it reportable to SEER? |
For this case only, it is reportable to SEER because the physician states that it isĀ "melanoma in situ." The phrase "proliferation of atypical melanocytes confined to epidermis" alone is not reportable to SEER. This phrase means that there are a number of (proliferation) pigmented cells (melanocytes) not showing the normal cell structure (atypical). |
2004 | |
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20041090 | CS Extension/CS Mets at Dx--Lung: How are these fields coded for bilateral pleural effusion for a right lung primary? A code of 72 in the CS Extension field leads to a T4, but bilateral pleural effusion is M1. Should CS Mets at Dx be coded 39? | 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 bilateral malignant pleural effusion, code the ipsilateral malignant effusion in CS Extension and the contralateral malignant effusion in CS Mets at Dx. Assuming the bilateral pleural effusion is the furthest extension in this case, code CS Extension to 72 [Malignant pleural effusion]. Code CS Mets at Dx to 40 [Distant mets, NOS]. |
2004 |