Question: 20190004

Status


Final

Category


#1:   Systemic / Surgery Sequen
#2:   Bladder
#3:  


References


Source 1:   2018 SEER Manual
pgs:   214
Notes:   draft version
Source 2:  
pgs:  
Notes:  


Question


Systemic/Surgery Sequence: Does the Systemic/Surgery Sequence field apply to only the first surgery performed (Date of First Surgical Procedure) or does it apply to the most definitive surgery (Date Most Definitive Surgery) as well? See Discussion.

 



Discussion


Example: Bladder primary with transurethral resection of the bladder tumor (TURBT) on 2/17/2017 (Date of First Surgical Proc) followed by a second TURBT on 3/24/2017 (Date Most Definitive Surgery) with mitomycin C instilled on the second, most definitive TURB procedure.

There is an edit failure (IFX166) when Systemic/Surgery Sequence is coded 5 (intra-operative systemic) and Systemic Date does not match Date of First Surgical Procedure. How should we capture the intra-operative systemic treatment during the second, most definitive TURB? Is the correct Surgery/Systemic Sequence code 3 (systemic after surgery) for this case because (intra-operative) chemo was technically given after the first surgery?



Answer


Assign code 3 to Systemic/Surgery Sequence and document the intraoperative treatment in the text field.  Surgery is defined as a Surgical Procedure to the Primary Site (codes 10-90), Scope of RLN Surgery (codes 1-7), or Surgical Procedure of Other Site (codes 1-5) in the 2018 SEER Manual.  In this case, the treatment was after the first surgical procedure.



History




Last Updated


01/02/2019

Date Finalized


02/14/2019