Report | Question ID | Question | Discussion | Answer | Year |
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20000261 | EOD-Extension--Lymphoma: What code is used to represent a non-Hodgkin lymphoma presenting with involvement of an extralymphatic organ and lymph nodes on the opposite side of the diaphragm? | For cases diagnosed 1998-2003: Code the EOD-Extension field to 31 [30 + localized involvement of an extralymphatic organ or site; Stage III E]. | 2000 | |
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20000428 | EOD-Clinical Extension--Prostate: How do you distinguish between clinical extension codes of 10, 13, 14, and 20 for cases with a benign prostate per digital rectal exam that appear localized after TURP/prostatectomy? Can the clinical extension code of 10 be used if the term "microscopic carcinoma" is noted in the pathology report without also mentioning "foci" or "Stage A" for clinically inapparent tumors? | For cases diagnosed 1998-2003:
When the prostate feels benign and the cancer is found incidentally at the time of the microscopic exam, code the EOD-Extension field to 10 [number of foci or % of involved tissue not specified]. Code as 13 (less than or equal to 5%) or 14 (greater than 5%) if percentage involved is given in the tissue resected. If the path report states "solitary focus of carcinoma" without mentioning the total amount of tissue resected, code extension to 13. If there is more than one focus, code extension to 10. Don't assign a code of 20 unless the tumor is clinically apparent. |
2000 | |
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20000532 | EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined: Should a lymph node biopsy be counted in these fields or are these fields for lymph node dissections only? See discussion. | Example: 1) Lymph node biopsy: adenocarcinoma. 2) Lymph node dissection: 4/15 regional lymph nodes positive for adenocarcinoma. | For cases diagnosed 1998-2003:
These fields record the number of regional lymph nodes examined pathologically whether from a biopsy or from a dissection. If the single lymph node biopsied was a regional lymph node, code the Number of Regional Lymph Nodes Positive field to 05 and the Number of Regional Lymph Nodes Examined field to 16. If the lymph node biopsied was a distant node, code these fields to 04 and 15 respectively. |
2000 |
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20000270 | EOD-Lymph Nodes--Lung: What code is used to represent this field when the only information is a description of: 1. "hilar mass" 2. "mediastinal mass" 3. "enlarged" or "greater than 1 cm" used to describe any of the lymph nodes listed under code 2 in the EOD Lymph Nodes field? |
For cases diagnosed 1998-2003:
Code EOD-Lymph Nodes fields as follows for the examples given:
1) 9 [Unknown; not stated] for a "hilar mass" 2) 2 [Mediastinal] for a "mediastinal mass" 3) 2 [Mediastinal] for "enlarged" or "greater than 1 cm," if used to describe any of the named lymph nodes listed under code 2 in the EOD-Lymph Nodes field. |
2000 | |
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20000535 | EOD-Pathologic Extension--Prostate: Is extracapsular extension implied by the following phrases: "case staged as C" and "case staged as T3a"? See discussion. | Example: A prostatectomy was done on 6/29. The physician staged the case as a "C" on 7/2 and as T3a on 8/6. It appears the physician is interpreting the following pathology information as unilateral extracapsular extension: "The tumor on the right extends to the inked surface of the gland. In this area the capsule appears absent." Should pathologic extension be coded to unilateral extracapsular extension [42]?
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For cases diagnosed 1998-2003:
Yes. Use the best information available to stage this case. In this case, the best information is the physician's statement that the case is stage T3a. Without any additional information, the EOD-Extension field is coded to 42 [Unilateral extracapsular extension (pT3a)] on the basis of the T3a stage by the MD. When there is a conflict between different staging systems, default to the AJCC stage. |
2000 |
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20000280 | Primary Site--Breast: Is there a hierarchy for coding subsite for breast cases when there is conflicting information in the physical exam, mammogram, operative and pathology reports as to the exact location of the primary? See discussion. | Example: Two mammograms were performed. One report indicates the lesion is at 12:00 and the other indicates it is in the upper central quadrant. However, the pathology report from the modified radical mastectomy specimen indicates the mass is in the UIQ.
According to one of our physicians, when a pathologist has a mastectomy specimen with attached axillary contents, the location of the lesion (subsite) is very accurate. |
Code the Primary Site field to C50.2 [upper inner quadrant]. In general, the priority for using information is pathologic, operative, and clinical findings. The pathology report would take precedence in this case. The 2004 SEER Program Code manual will include the following instructions for determining breast subsite. Priority Order for Coding Subsites Use the information from reports in the following priority order to code a subsite when the medical record contains conflicting information: 1 Pathology report 2 Operative report 3 Physical examination 4 Mammogram, ultrasound If the pathology proves invasive tumor in one subsite and insitu tumor in all other involved subsites, code to the subsite involved with invasive tumor. |
2000 |
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20000547 | Histology (Pre-2007): What code is used to represent the histology "non-small cell carcinoma, NOS"? See discussion. | Should a non-small cell carcinoma histology be assumed to be a large cell carcinoma [8031/3] or should the histology be coded to carcinoma, NOS [8010/3]? | For tumor diagnosed 2001-2006: Code the Histology field to 8046/3 [non-small cell carcinoma].
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. |
2000 |
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20000849 | Primary Site--Lymphoma: How should you code the primary site for a lymphoma that presents with involvement of an extranodal site and regional lymph nodes? See discussion. | 1. Lymphoma involves the spleen and the splenic lymph nodes.
2. MALT Lymphoma involves the stomach and the gastric and iliac lymph nodes. |
1. Code the Primary Site field to C42.2 [spleen].
2. Code the Primary Site field to C16._ [stomach].
When lymphoma presents in an extranodal site and in the regional lymph nodes for that extranodal site, code the Primary Site field to the extranodal site. The typical disease process is that lymphoma can spread from an extranodal organ to its regional lymph nodes. It cannot metastasize from the regional lymph node to the extranodal organ. The exception to this would be if the lymph nodes presented as one large mass that extended into the regional organ. |
2000 |
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20000555 | EOD-Extension--Ovary: What code is used to represent this field for an ovarian primary presenting with "spread to the omentum"? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 75 [Peritoneal implants, NOS] because the size of the implants on the omentum is not known.
Note 6 was added to the EOD scheme which states that both direct extension and discontinuous metastasis to the omentum are coded in the range 70-75 depending on how the peritoneal implants are described. |
2000 | |
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20000512 | EOD-Extension/EOD-Lymph Nodes--Kaposi Sarcoma: What code is used to represent this field for a Kaposi sarcoma with no skin lesions but positive lymph node and bone marrow biopsies? | Code the EOD-Extension field to 13 [Visceral (e.g., pulmonary, gastrointestinal tract, spleen, other)], because of the positive bone marrow. Code the EOD-Lymph Nodes field to 3 [Both clinically enlarged palpable lymph nodes (adenopathy) and pathologically positive lymph nodes], for the pathologically positive node.
Note: Potential revision of the extension scheme will be referred to SEER Medical Advisory Group (SMAG). |
2000 |