SEER Inquiry System - Report
Produced: 01/17/2025 6:27 PM
Question 20180049
Inquiry Details
References:
Solid Tumor Rules. Lung
Question:
Solid Tumor Rules (2018)/Histology--Lung: What is the difference between Lung Rules H7 and H8 (Single Tumor Module)? When would one use H8 rather than H7? See Discussion.
Discussion:
Is Rule H8 a duplicate of Rule H7? Rule H7 instructs one to use Table 2 when there are multiple histologies and the combination is listed in Table 2 (or a combination code was received from Ask a SEER Registrar). Rule H8 states to code adenocarcinoma with mixed subtypes (8255) when there are multiple adenocarcinoma subtypes OR any combination of histologies which are not listed in Table 2. However, both conditions for Rule H8 are already included in Table 2 (the last row). How would one ever move past Rule H7 if all the conditions for both Rules H7 and H8 are covered first under Rule H7?
Example: A resection pathology report proves invasive adenocarcinoma, acinar, solid and papillary types. Rule H7 seems to be the first H Rule that applies as there are multiple histologies (identified using a reportable term: type) AND the combination is listed in Table 2. The last row of Table 2 instructs one to code Adenocarcinoma with mixed subtypes (8255) when there are at least two of the subtypes/variants of adenocarcinoma listed in Column 1 (Required Terms). In this case, there were three subtypes/variants that are listed in Column 1 (acinar, solid and papillary). However, Rule H8 also instructs one to, Which rule applies here, Rule H7 or Rule H8?
Answer:
January 2019 update: The differences between H7 and H8 are H8 applies to tumors with multiple subtypes of adenocarcinoma while H7 applies to histology combinations other than adenocarcinoma such as adeno and squamous.