Report | Question ID | Question | Discussion | Answer | Year |
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20021005 | EOD-Extension--Lymphoma: What code is used to represent this field for an extranodal lymphoma that has more than one tumor in the primary site OR has intraluminal extension from the primary site to an adjacent organ? See discussion. | 1. Small lymphocytic lymphoma with 2 tumors in the stomach. 2. Lymphoma involving the cecum and ileum. 3. Lymphoma of the fundus of stomach with extension into the esophagus. |
For cases diagnosed 1998-2003:
Using the EOD scheme for lymphoma, code the Extension field to 11 [Localized involvement of a single extralymphatic organ or site; Stage IE] for all 3 of these cases.
For the stomach lymphoma: There are 2 areas of lymphoma, but it is still confined to one site.
For the other 2 lymphomas: Intraluminal (mucosal) spread of the lymphoma never equals extension. The same phrase that was added to code 21, "Direct extension to adjacent organs or tissues", will be added to code 11 in the Collaborative Stage System. Neither "mucosal spread to a contiguous organ" or "direct extension into a nearby organ" affect staging. Both are still coded to 11 as long as there are no other sites of lymphoma involvement.
EOD code 80 is poorly written. It does not mean diffuse invovement or multiple tumors in a single organ but rather "diffuse disease in two or more organs." |
2002 |
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20021006 | EOD-Extension--Hematopoietic, NOS: If a solitary plasmacytoma originates in the right tonsil and extends to the left tonsil, vallecula and hypopharynx, is extension still coded to 10 [localized disease, solitary plasmacytoma only]? | For cases diagnosed 1998-2003:
Code the EOD-Extension field to 10 [localized disease, solitary plasmacytoma only] for all cases of solitary plasmacytoma. |
2002 | |
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20020060 | Terminology/EOD-Size of Primary Tumor--Lung: Can the term "opacity" be used to code the size of the primary lung tumor when it is given a size in an imaging study but the "opacity" is not referred to as being suspicious for cancer? See discussion. | Example: How do you code tumor size for a lung primary in which the patient had a CT of the chest that describes a "4 cm opacity in the RUL of the lung." A biopsy of the RUL lung is positive for carcinoma? Would your answer be different if the opacity was described as being "suspicious for carcinoma"? | For cases diagnosed 1998-2003:
Code the EOD-Size of Primary Tumor field to 999 [Not stated] for the example given above. However, if the opacity was described as a "mass" or as "suspicious for cancer," the size could be coded to 040 [4 cm]. |
2002 |
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20021131 | EOD-Extension: If extension/metastasis is found within 4 months of diagnosis, but after first course of cancer-directed therapy has ended, should that involvement be excluded when coding the EOD-extension field? See discussion. | Example: Spinal drop metastasis was diagnosed within 4 months of the initial diagnosis of a localized astrocytoma, but after treatment with surgery and XRT was completed. | For cases diagnosed 1998-2003:
Do not include the spinal metastasis because it was diagnosed after the extent of disease was established. If metastasis was not present at diagnosis, and not discovered during the original metastatic work-up, it is progression of disease. |
2002 |
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20021141 | EOD-Extension--Lung: When only minimal information is available, such as scans and needle biopsies, should EOD extension be coded to localized or unknown? See discussion. | The patient was diagnosed with non-small carcinoma of the lung by needle biopsy of the right upper lobe Feb. 2, 2001. History revealed that CT performed prior to needle bx showed 2 right sided lung lesions and right hilar adenopathy. Chest x-ray following needle bx showed irregular opacity within the RML appears unchanged. Soft tissue prominence in the azygos region, possibly related LN enlargement. This is the only information available.
Should we code extension as 30 [localized, NOS]? |
For cases diagnosed 1998-2003:
Code the EOD-Extension field to 99 [unknown] if no additional information is available for this case. Because the second lesion in the right lung could be malignant, the extension code might be 77 [separate tumor nodule(s) in different lobe]. With the possibility of a more extensive stage, the status of the hilar lymph nodes is also not clear. The abstracted information is insufficient to stage this case. |
2002 |
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20021020 | First Course Treatment: 1) When is Decadron (Dexamethasone) coded as cancer treatment? 2) When Decadron is given to a patient with multiple myeloma, is it coded as treatment only if given in combination with chemotherapy? See discussion. |
SEER Book 8 states that Decadron is an important therapeutic agent for treatment of multiple myeloma. In the Abstracting and Coding Guide for the Hematopoietic Diseases, Decadron is a hormonal treatment for multiple myeloma "when given as part of a chemotherapy regimen". |
For cases diagnosed 1/1/2003 and after: 1. Code hormone therapy to 01. Code any therapy administered to treat cancer tissue that achieves its effect on cancer tissue through a change in the hormone balance in the hormone therapy field. Decadron is coded for leukemias, lymphomas and multiple myelomas primaries. It is coded for other sites only when stated to be cancer-directed treatment. 2. Code hormone therapy to 01. Decadron should be coded as hormone therapy for multiple myeloma when given alone or as part of a first course of treatment chemotherapy regimen. |
2002 |
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20020018 | EOD-Lymph Nodes/EOD-Pathologic Review of Number of Regional Lymph Nodes Positive and Examined--Cervix: What codes are used to represent these fields for a cervix primary when the only information on lymph nodes is a CT of the pelvis showing "pelvic adenopathy" (no surgery was done)? | Code the EOD-Lymph Nodes field to 9 [unknown]. Code the Pathologic Review of Number of Regional Lymph Nodes Positive field to 98 [No nodes examined] and the Lymph Nodes Examined to 00 [No nodes examined] because there was no resection of the primary organs. Adenopathy, NOS, per SEER guidelines, is not coded as lymph node involvement | 2002 | |
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20021091 | Reportability--Hematopoietic, NOS: Are the terms "thrombocytosis, NOS" and "thrombocythemia, NOS" non-reportable to SEER? See discussion. |
Our understanding from SEER about how to classify these types of clinical impressions for the 2001 and later reportable blood diseases is as follows: If we cannot prove that it is malignant, then we should be conservative and exclude the case for reporting to SEER. |
For cases diagnosed prior to 1/1/2010:The terms "thrombocytosis, NOS" and "thrombocythemia, NOS" are not reportable to SEER. For cases diagnosed 2010 forward, refer to the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database (Hematopoietic DB) provided by SEER on its website to research your question. If those resources do not adequately address your issue, submit a new question to SINQ. |
2002 |
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20020057 | Histology (Pre-2007)--Melanoma: What code is used to represent the histology "radial growth phase: melanoma, superficial spreading type; vertical growth phase: epithelioid type"? See discussion. | Can the "growth phase" be used to code histology? If so, would the histology be epithelioid cell melanoma (8771/3)? | For tumors diagnosed prior to 2007:
Code the Histology field to 8771/3 [epithelioid cell melanoma]. The "growth phase" information in this case describes the horizontal spread and the "invasive" or vertical growth through the layers of skin.
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. |
2002 |
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20021115 | EOD-Lymph Nodes--Testis: In coding lymph node involvement for a testicular primary, should we use code 5 (Size not stated) when there is not a pathologic size of the lymph node provided? See discussion. | Should Note 1 in the testis EOD be changed to "Metastases in lymph nodes are now measured by the size of the lymph node as stated in pathology report"? The SEER EOD-88, 3rd Edition, states that "when size of regional lymph nodes is required, code from the pathology report." | For cases diagnosed 1998-2003:
For testis cases only, "metastasis in lymph nodes" is measured by the size of the lymph node or the lymph node mass. It is acceptable to code the size of this metastasis from a CT scan or other imaging when a pathology specimen is not available for testicular primaries. |
2002 |