| Report | Question ID | Question | Discussion | Answer | Year |
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20041005 | EOD-Extension--Retroperitoneum: Does the presence of "necrotic masses, NOS" in the blood, which are not pathologically evaluated, affect the coding of this field? See Description. | Encapsulated malignant tumor within the retroperitoneum was removed. Surgical report: "In the abdomen, blood had necrotic masses floating freely and encapsulated a 3-4" mass." No pathologic assessment of the necrotic masses is available. | For cases diagnosed 1998-2003: Necrotic masses do not affect the EOD-extension code. | 2004 |
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20041023 | Histology (Pre-2007)--Lung: Should "moderately differentiated adenocarcinoma of scar type, intermixed with bronchiolo-alveolar carcinoma" be coded to 8250 [bronchiolo-alveolar adenocarcinoma, NOS] or 8255 [adenocarcinoma of mixed subtypes]? | For tumors diagnosed prior to 2007:
Code Histology to 8255 [Adenocarcinoma with mixed subtypes]. This is a single tumor containing both a scar carcinoma and a bronchiolo-alveolar carcinoma--use 8255. The synonym for 8255 is adenocarcinoma combined with other types of carcinoma (not just subtypes).
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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20041075 | CS Tumor Size: Can we take the size of a "polypoid" mass? See Discussion. | 3/04 Colonoscopy: 4 cm semi-circumferential friable mass in sigmoid colon. Path: Tubulovillous adenoma indeterminate for malignancy. 4/04 Sigmoid Colectomy: 5 x 4 polypoid mass: WD Adenocarcinoma arising in a tubulovillous adenoma. Define "Polypoid". Size of "polypoid" mass. Would the size be coded to 050 or 999? |
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.If the pathology report confirms that the entire polyp is malignant, code the size of the polyp/polypoid mass. If the pathology report does not confirm that the entire polyp is malignant, code 999. Code tumor size as 999 [Unknown] for the example above. Do not code the size of the polypoid mass in this example. The size given above is the size of the polypoid mass, not the size of the malignancy. Polypoid means "Like a polyp. |
2004 |
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20041050 | Surgery of Primary Site--Rectum: How do you code a procedure described as a "transanal resection, debulking of a large rectal mass"? See Discussion. | Patient is not a surgical candidate due to "other medical conditions". Colonoscopy done for anemia and rectal bleeding. At the colonoscopy a "Transanal Resection Debulking of large rectal mass" is performed. Two specimens are sent to the lab. The first is labeled "rectal mass" and is a 2.0 cm diameter spherical fragment of tissue. The second is labeled "transanal debulking rectal mass" and is described as multiple, irregular shaped fragments of tan, rubbery tissue measuring 5.0 x 5.0 x 3.0 cm. Final path diagnosis: Debulking of rectal mass: Adenocarcinoma greater than 2 cm in size, resection margins positive for tumor. | For cases diagnosed 1998-2002, code Surgery of Primary Site to 20 [Local tumor excision, NOS]. Because the procedure was performed via colonoscopy and apparently did not involve proctectomy, the best choice is a local excision. | 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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20041051 | 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. | 2004 | |
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20041053 | CS Site Specific Factor 6--Breast: Can we interpret the in situ component as "minimal" when the pathology report states "1.1 cm infiltrating duct carcinoma and no extensive intraductal component"? | 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. Yes. Based on the information provided above, the in situ component is "mininmal" for the purpose of coding Breast CS Site Specific Factor 6. The phrase "no extensive intraductal component" suggests that there is some intraductal carcinoma present. |
2004 | |
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20041083 | CS Lymph Nodes/CS Reg Nodes Eval -- Rectum: If the rectal tumor is not treated with a resection but on endoscopic ultrasound the patient is stated to have a lymph node above the primary tumor and the physician stages the case clinically as N1, should the CS Lymph Nodes field be coded to 30 [Regional lymph node(s), NOS] or 10[Rectal, NOS]? Should the evaluation field be coded to 0 [No lymph nodes removed. Evidence based on other non-invasive clinical evidence] or 1 [No lymph nodes removed. Evidence based on endoscopic examination.]? See Discussion. | Rectal primary: 5/04 sigmoidoscopy w/bx of rectal mass: adenocarcinoma. 6/04 Endoscopic ultrasound of rectal mass: invasion through wall but no definite invasion of prostate or seminal vesicles; 7.5mm lymph node located above tumor, no other enlarged lymph nodes detected. Patient did not have surgery. Physician staged lymph node involvement to clinical N1. |
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 Lymph Nodes code 10 [Regional lymph nodes] based on the physician's N1. Assign code 10 because it is the lowest numerical CS code that corresponds to N1 in the scheme for rectum. Use the physician's assignment of TNM when the information in the medical record is incomplete or ambiguous. Code CS Reg Nodes Eval field 0 [No lymph nodes removed] for the case described above because there is no indication that N1 was assigned based on the endoscopic exam. The NI may be based solely on TNM documentation provided by the clinician and you do not know what the clinician used as the basis for the staging. |
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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20041030 | Histology (Pre-2007)--Lung: What is the correct histology code for this case of squamous cell carcinoma with several different variants? See Discussion. | The path report from a left pneumonectomy says: This squamous cell carcinoma had several different variants present including typical non-keratinizing squamous cell, spindled cell squamous cell, clear cell squamous cell and a small cell variant of squamous cell. I cannot find a combination code that fits; the majority of the tumor is not stated; so do you code the highest specific type mentioned - 8084 - Squamous cell, clear cell type? |
For tumors diagnosed prior to 2007:
Assign histology code 8070 [squamous cell carcinoma, NOS]. Squamous cell carcinoma, NOS includes types of squamous cell carcinoma without a specific code. This is a combination squamous tumor that does not have a unique code.
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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