Question: 20200035

Status


Final

Category


#1:   Reportability
#2:   Ambiguous terminology
#3:   Brain and CNS


References


Source 1:   2018 SEER Manual
pgs:   10, 79
Notes:  
Source 2:  
pgs:  
Notes:  


Question


Reportability/Ambiguous Terminology--Brain and CNS:  Is the expression differential considerations a synonym for differential diagnoses? See Discussion.



Discussion


Example: An MRI Spine showed a large expansile mass arising from the sella turcica and extending into the suprasellar cistern, but the radiologist only noted: The leading differential considerations include pituitary macroadenoma or a large suprasellar base meningioma. The patient was subsequently pathologically diagnosed with a pituitary adenoma. It is unclear if the diagnosis date should be coded to the MRI date.

There are two existing SINQ questions regarding the term consider. SINQ 20061094 confirms a diagnosis that is considered to be is reportable because it is unambiguous, but SINQ 20081033 states the phrase malignancy is highly considered is not a reportable ambiguous term.

How should we interpret differential considerations? If differential considerations is equivalent to a differential diagnosis, then this patient was clinically diagnosed on imaging. However, if differential considerations is not reportable, then there was no diagnosis prior to the resection.



Answer


In an ideal situation, the radiologist should be consulted to determine what he/she meant by "differental considerations." If that is not possible, given the context and usage, "differential considerations" in this case can be interpreted as differential diagnoses. And since the two differential considerations are both reportable, this case is reportable as of the date of the MRI.



History




Last Updated


07/20/2020

Date Finalized


09/02/2020