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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 extension 99 [Extension unknown]. This prostate cancer was not clinically evident; it cannot be clinically assessed based on the information provided.

Note: This is an unusual case. A DRE was performed and a nodule was palpated on the right that was not cancer. The other lobe is presumed to have been negative because it was not mentioned.

For cases diagnosed 2007 or later:

For coding purposes, this is a papillary and follicular combination that would be coded to the combination code 8340/3 [Papillary carcinoma, follicular variant].

For thyroid cancer only, the term micropapillary does not refer to a specific histologic type. It means that the papillary portion of the tumor is minimal or occult, usually less than 1 cm. in diameter.

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 prostate CS Extension to 99 [Extension unknown] and code CS Tumor Size according to the information available from the surgery.

CS Extension code 95 [No evidence of primary tumor] should be used only in that rare situation when the only evidence of disease is distant mets or lymph node involvement, no primary tumor found. That is why CS tumor Size must be 000 when CS Extension code 95 is used.

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 extension code 50 [extension or fixation to adjacent structures] based on the term "fixed." Fixation to a particular structure(s) does not have to be specified in order to use code 50.

Do not use the statement "hard" to determine CS extension.

For cases diagnosed 2007 or later:

As long as this is NOT urothelial carcinoma extending to the prostatic ducts, code histology to 8140/3 [adenocarcinoma] using rule H10.

Do not code histologies designated as "focal."

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].

For cases diagnosed 2007 or later:

Using the pre-2007 multiple primary rules, the PTCC of the bladder in 2000 and the invasive TCC of the right ureter in Nov. 2004 would have been abstracted as separate primaries.

Use the 2007 MP/H rules to evaluate the May 2007 diagnosis. Start with rule M3. Stop at rule M8. The May 2007 diagnosis is the same primary.

Rule M4 does not apply because of the 2000 bladder primary. A clarification will be added to M4 to stress that for the urinary rules, any urinary tumor up to the present point in time is counted when applying this rule.

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.

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 PSA recorded in CS SSF 1 and 2 must be documented in the medical record. Record the highest PSA value prior to diagnostic biopsy or treatment. If the highest PSA value documented in the medical record is from the previous year, record it.