Report | Question ID | Question | Discussion | Answer | Year |
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20061058 | CS Site Specific Factor--Prostate: Can autopsy results also be used when coding SSF3, pathologic extension, given that the instructions only address the use of prostatectomy findings when coding this field? |
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2. If the prostate cancer was diagnosed on autopsy, or the autopsy was performed within the staging timeframe (See 2004 SEER Manual, page 112), code SSF3 using the autopsy information. |
2006 | |
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20100064 | Histology--Heme & Lymphoid Neoplasms: How is histology to be coded for acute lymphoblastic leukemia (ALL) and/or precursor B acute lymphoblastic leukemia (Pre-B ALL) for cases diagnosed 2010 and later? The Heme Database has two histology codes for this disease, both 9811/3 and 9836/3, which is the correct histology code? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code histology to 9811/3 [B lymphoblastic leukemia/lymphoma, NOS].
See the Abstractor Notes section in the Heme DB, when determining how to code histology for a case. It indicates the code 9811/3 is effective for cases diagnosed 2010 and forward. The 9836/3 is listed as obsolete and refers you to code 9811/3. Make sure to check for a specific subtype of B lymphoblastic leukemia/lymphoma [9812/3 - 9818/3] before assigning the NOS code [9811/3].
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2010 | |
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20110146 | Multiple primaries--Heme & Lymphoid Neoplasms: How many primaries are to be accessioned when a patient was diagnosed in 2003 with malignant lymphoma, mixed cell type, follicular in the inguinal lymph nodes and was recently diagnosed with follicular lymphoma (by a neck lymph node biopsy) involving the neck and mediastinal lymph nodes? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
This case should be accessioned as a single primary: malignant lymphoma, mixed cell type, follicular [9691/3] diagnosed in 2003. The following describes how this determination was made.
This case is one in which the terminology for follicular lymphoma has changed over time. In 2003, follicular lymphoma was classified as small cleaved cell, large cell, or mixed cell (both small cleaved and large cell). Those designations are no longer used. This disease process is currently classified as follicular lymphoma NOS, grade 1, grade 2 or grade 3. The change was simply a change in classification/terminology.
Appendix A, Table A3 (Obsolete Terms as Defined in ICD-O-3, Lymphoid Neoplasm Obsolete Terms) should be used to determine the current term when an obsolete term is known/given. Per the Table, "Mixed cell type follicular lymphoma" is currently known as "Follicular lymphoma, grade 2" and the correct histology code is 9691/3. This is the correct histology for the 2003 primary.
Per Rule M15, the histologies must be check in the Multiple Primaries Calculator to determine the number of primaries. Enter [follicular lymphoma, grade 2 (malignant lymphoma, mixed cell type, follicular)] for Histology Code 1 and [follicular lymphoma, NOS] for Histology Code 2. The result is "Same Primary." As a result, accession a single 2003 diagnosed primary with the histology follicular lymphoma, grade 2 [9691/3] when the patient is subsequently diagnosed with follicular lymphoma, NOS.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2011 | |
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20120012 | Histology--Heme & Lymphoid Neoplasms: How is histology coded if the pathology report shows diffuse large B-cell lymphoma arising in a small cell lymphoma - Richter's transformation, also compatible with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL)? | For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph.
Code the histology to 9680/3 [diffuse large B-cell lymphoma (DLBCL)].
For CLL (and CLL/SLL), Richter's transformation represents when CLL changes into DLBCL. In this case, there was a biopsy that demonstrated a diagnosis of the chronic disease (CLL/SLL) transforming (Richter's transformation) into an acute disease DLBCL.
Per Rule M8, one is instructed to abstract the acute neoplasm as a single primary when both a chronic (CLL/SLL) and an acute neoplasm (diffuse large B-cell lymphoma (DLBCL)) are diagnosed simultaneously there is documentation of only one positive bone marrow biopsy, lymph node biopsy or tissue biopsy.
SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2012 | |
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20071125 | Radiation Therapy--Prostate: Is the regional treatment modality XRT best coded to 50 (brachytherapy, NOS), 53 (LDR) or 54 (HDR) when the documentation indicates only "I-125 seeds" to the prostate? | Assign code 53 [Brachytherapy, interstitial, LDR] for seeds to the prostate. Seeds are always low dose because they are left in place and the radioactivity decays over time. | 2007 | |
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20000270 | EOD-Lymph Nodes--Lung: What code is used to represent this field when the only information is a description of: 1. "hilar mass" 2. "mediastinal mass" 3. "enlarged" or "greater than 1 cm" used to describe any of the lymph nodes listed under code 2 in the EOD Lymph Nodes field? |
For cases diagnosed 1998-2003:
Code EOD-Lymph Nodes fields as follows for the examples given:
1) 9 [Unknown; not stated] for a "hilar mass" 2) 2 [Mediastinal] for a "mediastinal mass" 3) 2 [Mediastinal] for "enlarged" or "greater than 1 cm," if used to describe any of the named lymph nodes listed under code 2 in the EOD-Lymph Nodes field. |
2000 | |
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20010110 | Grade, Differentiation--All Sites: Should we take the grade from a TNM staging form over a grade stated in a pathology report when the grade mentioned on the TNM staging form is a higher grade (e.g., Pathology report diagnosis is moderately differentiated adenocarcinoma, Gleason's 3+3=6, but the physician checked "poorly differentiated" on the TNM form)? | Code the Grade, Differentiation field to 2 [moderatley differentiated]. Code from the pathology report over the TNM staging form. If you do not have access to the path report, use the grade from the TNM form. | 2001 | |
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20110127 | Primary Site--Brain and CNS: Are meninges surrounding cranial nerves cranial meninges [C700] or a part of the specific nerve's sheath? Is the primary site for an optic nerve sheath meningioma coded to optic nerve [C723] or cranial meninges [C700]? |
Code the primary site to cranial meninges [C700]. |
2011 | |
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20120072 | Primary site--Heme & Lymphoid Neoplasms: How is the primary site coded for a diagnosis of multifocal Langerhans cell histiocytosis with involvement of the bone, liver, spleen and retroperitoneum? |
For cases diagnosed 2010 and forward, access the Hematopoietic Database at http://seer.cancer.gov/seertools/hemelymph. Per Rule PH30, use the Heme DB to determine the primary site and histology when rules PH1-PH29 do not apply. Code the primary site to C419 [bone, NOS], assuming there are multiple bones involved in this case. If only one bone is involved, code the primary site to the specified bone. In the Abstractor Notes section in the Heme DB, it indicates the primary site may differ for LCH in the solitary disease and multisystem disease. This patient has multisystem disease with involvement of the bone, liver, spleen and retroperitoneum. The most common sites for multisystem involvement include three of the four above sites (bone, liver, and spleen). Determine the primary site based on the knowledge of the usual sites of involvement for this disease, the actual sites of involvement for the case presented, and identifying which sites of involvement are likely metastatic and which are the potential primary sites. There are two potential primary sites of involvement: the bone and the retroperitoneum. Bone is a common site of involvement for LCH while the retroperitoneum is not. Code the primary site to C419 [bone, NOS] because multiple bones are involved for this patient and bone is the most common site for LCH based on the documentation in the Abstractor Notes. The spleen and liver are typically not primary sites for this disease process. They become involved when there is multisystem involvement because they filter the blood. They are typically sites of metastatic involvement. This information will be added to the ABSTRACTOR NOTE section. SEER*Educate provides training on how to use the Heme Manual and DB. If you are unsure how to arrive at the answer in this SINQ question, refer to SEER*Educate to practice coding hematopoietic and lymphoid neoplasms. Review the step-by-step instructions provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. https://educate.fhcrc.org/LandingPage.aspx. |
2012 | |
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20081124 | CS Extension--Brain and CNS: How is CS Extension coded for a malignant meningioma that demonstrates extension into adjacent brain tissue? For malignant brain tumors, code 60 represents extension into the meninges. Would code 60 be the correct code for extension from a malignant meningioma into brain tissue? |
This answer was provided in the context of CSv1 coding guidelines. The response may not be used after your registry database has been converted to CSv2.Assign CS extension code 60 for malignant meningioma with extension to adjacent brain tissue. According to the I&R, this section of CS was taken directly from SEER Summary Staging, since AJCC does not have a staging system for these tumors. |
2008 |