Reportability: Is an AIN III that arises in perianal skin, skin tags or condyloma acuminatum reportable or must an AIN III arise in the anus or anal canal in order to be reportable?
AIN III arising in perianal skin [C445] is not reportable.
AIN III [8077/2] of the anus or anal canal is reportable.
Multiple Primaries (Pre-2007)--Head & Neck: How many primaries are abstracted if a patient has bilateral involvement of tonsils with the same histology (e.g. squamous cell carcinoma)? See Discussion.
Patient was initially found to have mass on right tonsil. Biopsy of right tonsil on June 16 showed invasive carcinoma, favor squamous cell. On July 17 patient underwent right neck dissection, radical resection of right tonsil tumor and left tonsillectomy. Right tonsil showed squamous cell carcinoma, poorly differentiated. Left tonsil showed squamous cell carcinoma, poorly differentiated. Microscopic report stated: Right tonsil: Invasion of deep peritonsillar tissue and skeletal muscle. Sections of left tonsil demonstrate squamous cell ca focally distributed in the tonsil, predominantly in situ, but with focal microscopic invasion. Path staged each tonsil specimen. Right tonsil was T2N1. Left tonsil was T1Nx.
For tumors diagnosed prior to 2007:
Code as two primaries. Squamous cell carcinoma diagnosed in both left and right tonsils are multiple primaries unless one is stated to be metastatic from the other.
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--Hematopoietic, NOS: How is an "advanced MDS (RAEB-T)/emerging AML" coded when discovered on a bone marrow biopsy?
For cases diagnosed prior to 1/1/2010:Code histology to 9984/3 [RAEB-T]. This particular MDS is refractory anemia with excess blasts in transformation. It has not yet progressed to acute myeloid leukemia.
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.
CS Extension/CS Mets at Dx--Corpus uteri: Is a microscopic metastasis in a cul-de-sac implant more appropriately reflected in the CS Extension field code 80 [Further contiguous extension; cul-de-sac] or in the CS Mets at Dx field code 40 [Distant metastasis]?
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 80 [Further contiguous extension; Cul de sac] for CS extension in this case. Endometrium and ovary are exceptions to the rules that only contiguous extension is coded in Extension code 80. Only true distant metastases are coded in Mets at Dx.
CS Tumor Size/CS Site Specific Factor--Breast: Should the tumor size be coded to 1.5 cm or 2.5 cm and SSF6 coded to 020 or 030 respectively for a tumor with invasive and in situ components described as being a 2.5 cm tumor with a "greater than" 1.5 cm invasive portion? See Discussion.
Should tumor size be coded to 1.5 cm and SSF6 coded to 020 [Invasive and in situ components present, size of invasive component stated and coded in CS Tumor Size] or should the tumor size be 2.5 cm with SSF6 coded to 030 [Invasive and in situ components present, size of entire tumor coded in CS Tumor Size because size of invasive component not stated and in situ described as minimal (less than 25%)]?
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 CS tumor size 992 [stated as greater than 1 cm] and SSF6 code 020.
The September 2006 revision to the CS Tumor Size table now lists the 992-995 range codes as "greater than ___ cm."
It is better to code the invasive size than the entire size of the tumor. In the TNM mapping, this would more accurately portray the tumor as T1c rather than T2.
CS Extension/CS Mets: For primary sites within the peritoneum (abdominalpelvic walls) such as stomach, colon, does the presence of malignant ascites affect the coding of CS Extension or CS Mets?
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 Collaborative Staging system is governed by site-specific coding rules. Refer to each set of site rules rather than looking for a general answer for all sites in peritoneum. In particular, Ovary and Corpus allow malignant ascites to be coded in CS Extension, but not CS Mets at Dx. For each site, both CS Extension and CS Mets at Dx should be checked for the proper field to code malignant ascites.
Histology (Pre-2007)--Melanoma: How is histology coded for a final pathology diagnosis of "malignant melanoma, NOS" that is clinically described as a nevus?
For tumors diagnosed prior to 2007:
Code 8720 [malignant melanoma]. Assign the histology code based on the histology stated in the final diagnosis on the pathology report. The pathology report must say melanoma arising in junctional nevus to use the code 8740/3 [Malignant melanoma in junctional nevus].
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--Lymphoma: In the absence of physician staging, is an "enlarged" spleen seen on CT coded as involvement of the spleen for lymphoma cases?
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.
Do not code spleen involvement when the only evidence is an enlarged spleen.
When imaging is the only diagnostic tool (no biopsy or splenectomy), spleen involvement is based on the presence of nodules and not on enlargement. Splenic enlargement alone (by physical exam or imaging) is insufficient to support involvement of spleen.
Histology (Pre-2007)--Pancreas: Is a "composite mucinous adenocarcinoma and squamous cell carcinoma" coded to 8560 [adenosquamous carcinoma] or should 8480 [mucinous adenocarcinoma] be coded rather than 8070 [squamous carcinoma] because mucinous adenocarcinoma is a higher histology code than squamous carcinoma?
For tumors diagnosed prior to 2007:
Assign code 8560 [adenosquamous carcinoma]. According to our pathologist consultant, the mix of adenocarcinoma and squamous carcinoma is adenosquamous carcinoma. Adenosquamous tumors are rare, but known, representing 3-4% of pancreatic carcinomas.
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.
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