Report Produced: 02/04/2023 16:40 PM
|Report||Question ID||Question (Ascending)||Discussion||Answer|
|20051078||Surgery of Primary Site--Melanoma: If the surgical margins are greater than 1 cm for length and width but less than 1 cm for depth, do we code surgery in the 30-33 range?||Yes, assign a surgery code from the 30-33 range when any margin is less than 1 cm. Since tumor thickness is an important prognostic factor for cutaneous melanoma, the deep margin is of particular importance.|
|20081065||Surgery of Primary Site--Melanoma: Which surgery codes should be used for cases that have a 1 cm margin? See Discussion.||For a melanoma case the surgery codes in the 30's are to be used when margins are stated to be less than 1 cm. The codes in the 40's are to be used for cases where the margins are greater than 1 cm.||If the margin is exactly 1 cm, assign a surgery code from the 20-36 range. Use a code in the 40's only when the margin is greater than 1 cm.|
|20091032||Surgery of Primary Site--Ovary: How should this field be coded for an ovarian primary when there is a BSO and only the fundus of uterus is removed (not a full hysterectomy)?||Assign surgery code 52 [Bilateral (salpingo-) oophorectomy; WITH hysterectomy]. Code 52 does not exclude a partial hysterectomy.|
|20000476||Surgery of Primary Site--Ovary: What code is used to represent this field when a patient has a history of a previous organ removal and has additional surgery/organ removal for a present cancer (e.g., History of a 1984 hysterectomy and in 2003 has ovarian primary treated with BSO)?||For cases diagnosed 1/1/2003 and after: Code the Surgery of Primary Site field to 52 [Bilateral salpingo-oophorectomy WITH hysterectomy].|
|20110002||Surgery of Primary Site--Penis: How is CO2 laser treatment coded for penile cancer?||Assign code 14 [laser] for CO2 laser treatment given for primary penile cancer. The CO2 is the method used to deliver the laser.|
|20051062||Surgery of Primary Site--Prostate: How is the use of a Laserscope Niagara laser (modulated KTP-YAG laser beam (Niagara 122 prostate vaporization)) coded for prostate primaries? See Discussion.||The Laserscope Niagara laser performs an operation similar to the TURP, but there is virtually no bleeding and patients can sometimes go home the same day, most without a catheter. The laser is delivered through a fiber (the thickness of hair) into the cavity via an endoscope inserted through the urethra.||When performed as part of the first course of therapy, assign surgery code 15 [Laser ablation] to Niagara laser photovaporization of the prostate.|
|20081014||Surgery of Primary Site--Prostate: How is transurethral microwave treatment coded for prostate primaries?||
Assign code 16 [Hyperthermia]. See the SEER Note on page C-747 of the 2007 SEER Manual:
Code Transurethral Microwave Thermotherapy (TUMT) as 16.
|20100038||Surgery of Primary Site--Prostate: Is a prostate saturation biopsy coded under diagnostic biopsy or surgery?||A prostate saturation biopsy is a transperineal template-guided stereotactic saturation prostate biopsy that typically produces 30 to 80 core biopsies. This is an alternative biopsy technique used for some high-risk patients including men with persistently elevated PSA, those who have atypia on prior prostate biopsies, or men with biopsies showing high-grade prostate intraepithelial neoplasia (PIN). Although this is a different procedure, it is still a diagnostic biopsy. Do not code prostate saturation biopsy under Surgery of Primary Site.|
|20010025||Surgery of Primary Site--Prostate: What treatment code is used to represent prostate carcinoma treated with "high intensity focused ultrasound" (HIFU)?||
For cases diagnosed 1998 and later:
Code the Surgery of Primary Site field to 17 [Other method of local tumor destruction]. HIFU uses focused energy to destroy tissue. It is classified as a surgical procedure.
|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.|