Reportability--Hematopoietic, NOS: The Abstracting and Coding Guide for the Hematopoietic Diseases, page 47, states to determine whether the physician is using the term myelodysplasia to describe bone marrow marrow malfunction or a neoplasic syndrome in order to determine reportability. What do we do when there is no information one way or the other?
For cases diagnosed prior to 1/1/2010:Without further information, the term "myelodysplasia" alone is not reportable. If a more definitive diagnosis is made later, the case may become reportable.
For cases diagnosed 1/1/10 and later, 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.
MP/H Rules/Histology--Colon: Regarding histology rule H21, is there a hierarchy or do you code the higher histology if there is an adenocarcinoma arising in a polyp and an adenocarcinoma in a villous adenoma?
For cases diagnosed 2007 or later:
If you arrive at H21 and have an additional decision to make regarding the use of 8210, 8261 or 8263, you must make another pass through the histology rules. The second pass will determine which of the two or three histology codes to assign. The answer will vary depending of the specifics of the case.
Example:
Transverse colon: Adenocarcinoma in an adenomatous polyp involving muscularis propria and adenocarcinoma in a villous adenoma involving subserosa of transverse colon. Start with rule H15 because there are multiple tumors. Stop at H21 -- code either 8210 or 8261. To decide between 8210 and 8261, make a second pass through the histology rules, starting again with H15. Stop at H20. Code the histology of the most invasive tumor, 8210 [Adenocarcinoma in adenomatous polyp].
MP/H Rules/Multiple Primaries--Lung: How many primaries should be reported when an "adenocarcinoma" is discovered in one of several new nodules at the scar in a lung and it is less than a year after a wedge resection for a diagnosis of "bronchioalveolar adenocarcinoma" in the same lung? See Discussion.
In March 2006 patient diagnosed with bronchioalveolar adenocarcinoma [8250/3] and had wedge resection. In November 2006 a CT chest shows nodules at the scar suspicious for recurrence. In January, 2007, there was a biopsy of one of the nodules showing adenocarcinoma [8140/3].
Is this part of the original disease process diagnosed in March 2006 or should it be abstracted as a new primary based on 2007 MP/H rules (histology is different at the first 3 digits)?
For cases diagnosed 2007 or later:
Try to obtain more information/clarification on the 2007 diagnosis -- for example, is it metastasis?
Based only on the information provided for this case, the 2007 diagnosis is a separate primary.
Use the 2007 MP/H rules to assess the 2007 diagnosis. Begin with rule M3 in the multiple tumors section. Stop at rule M11, multiple primaries.
CS Extension/CS Lymph Nodes--Lung: How are these fields coded if a lobectomy path specimen indicates that two intrapulmonary lymph nodes are involved by direct extension from the primary tumor?
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 regional lymph node involvement in CS lymph nodes even when the lymph nodes are involved by direct extension. Do not code direct extension to lymph nodes in CS extension.
Radiation Therapy--Prostate: Is the regional treatment modality XRT best coded to 50 (brachytherapy, NOS), 53 (LDR) or 54 (HDR) when the documentation indicates only "I-125 seeds" to the prostate?
Assign code 53 [Brachytherapy, interstitial, LDR] for seeds to the prostate. Seeds are always low dose because they are left in place and the radioactivity decays over time.
MP/H Rules/Histology--Breast: If the abstractor only has the CAP protocol information from a pathology report and it does not include a "final diagnosis" label, which fields of the protocol are used to determine the histology and whether there is carcinoma in situ present in the specimen?
For cases diagnosed 2007 or later, if the CAP protocol is used in lieu of a final diagnosis, use all of the information in the CAP protocol.
Reportability--Brain and CNS: In addition to Schwannoma, are there additional types of benign tumors that arise in peripheral nerves along the spinal cord that are not reportable? See Discussion.
Are neuroepitheliomatous neoplasms such as ganglioneuroma, gangliocytoma, ganglioglioma occurring along the spinal cord reportable? Are nerve sheath tumors such as neuroma occurring along the spinal cord reportable? Angioma?
Reference: SINQ 20051071; Primary Central Nervous System Tumors, NPCR Training Materials 2004
Reportability depends on the location of the tumor. Tumors in the following sites are reportable:
C700 - C709
C710 - C719
C720 - C729
C751 - C753
Benign and borderline tumors of the peripheral nerves (C47_), including peripheral nerves along the spinal cord, are not reportable.
Please note: spinal schwannomas arising in the nerve root or spinal dura are reportable.
EOD-Pathologic Extension--Prostate: When coding a prostate case with a date of diagnosis prior to 1995, is the EOD-Pathologic Extension-Prostate field left blank?
For tumors diagnosed prior to 1995, leave EOD-Pathologic Extension--Prostate field blank.
Code all EOD fields according to the EOD coding scheme in effect for that year of diagnosis.
MP/H Rules/Histology--Prostate: While cases of "acinar adenocarcinoma" of the prostate are required to be abstracted with the histology code 8140/3 [adenocarcinoma, NOS] for cases diagnosed 1/1/07 or later, can 8550/3 [acinar adenocarcinoma] be used for cases diagnosed prior to 1/1/07? See Discussion.
The SEER Multiple Primary and Histology manual, effective with 2007 forward diagnosis dates, indicates that this histology should be coded to 8140/3 [adenocarcinoma, NOS]. Does this contradict ICD-O-3? Can acinar adenocarcinoma be coded for other primary sites?
For cases diagnosed 2007 or later, code acinar adenocarcinoma of the prostate as 8140/3.
Prior to diagnosis year 2007, code 8550/3 [acinar adenocarcinoma] may be used for prostate cases and for acinar adenocarcinoma of other sites, such as pancreas.
MP/H Rules/Histology--Brain: How many primaries are reported and what is the histology for a single brain tumor described as a low grade astrocytoma at the time of the initial partial resection and a low grade glioneuronal neoplasm at the time of the subsequent total resection? See Discussion.
On 4/20/07 a partial resection of a brain tumor is interpreted as low grade astrocytoma. Patient has a gross total resection on 8/13/07 with this diagnosis: low grade glioneuronal neoplasm (see comment). Comment: This case has been reviewed at ---. Dr. agrees with our interpretation (low grade glioneuronal neoplasm, possibly a dysembryoplastic neuroepithelial tumor).
For cases diagnosed 2007 or later, this is a single primary. A single tumor is always a single primary.
Assign histology code 9400/3 [Astrocytoma, low grade]. This diagnosis was not revised or amended based on the later surgery. It is possible that the malignant component was entirely removed during the first surgery.
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