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Please see the corrected levels below for the note. Note 4: If a Breslow's depth is given in the pathology report and there is no other indication of involvement, the following guidelines may be used (Note: If a physician documents a different Clark's Level than provided by these guidelines, go with the physician's Clark Level)

Code 000: Level I (In situ)

Code 100: Level II (< 0.75 mm Breslow's Depth)

Code 200: Level III (0.76 mm to 1.50 mm Breslow's Depth)

Code 300: Level IV (> 1.50 mm Breslow's Depth)

Thank you for bringing this to our attention.

The NAACCR Guidelines for ICD-O-3 Histology Code and Behavior Update Implementation, effective January 1, 2018, state: Currently in ICD-O-3, when a topography (C code) is listed in parentheses next to the morphology term, it indicates morphology is most common to that site. It may occur in other sites as well. Many of the new codes, terms, and behaviors listed in this update are site-specific and do not apply to all sites.

Please review the Comments to determine which histology codes are specific to sites. You may use sites not listed as the suggested site; however, it will generate an edit error for review and verification of the appropriate site.

Code chronic myeloid leukemia (CML) BCR-ABL1-positive as 9875/3.

According to the WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues, 4th edition, CML BCR-ABL1-positive is characterized by the chromosomal translocation t(9;22) which results in the formation of the Philadelphia (Ph) chromosome containing the BCR-ABL1 fusion gene. The diagnosis requires detection of the Ph chromosome and/or BCR-ABL1. If the mutation is detected, regardless of percentage, it is positive. Quantitative levels of BCR-ABL are used to monitor response to tyrosine kinase inhibitor therapy.

Accession two primaries, adenocarcinoma [8140/3] of the prostate [C619] and small cell neuroendocrine carcinoma [8041/3] of the prostate [C619] per Rule M17 of the Other Sites Solid Tumor Rules 2018, as these are different histologies with different histology codes at the second number.

Adenocarcinoma of prostate often manifests as a small cell carcinoma following treatment or as a progression of disease. It is important to capture these tumors as new primaries.

For mesothelioma, NOS (9050) and epithelioid mesothelioma (9052) of the peritoneum for females, assign C481, C482, or C488 as appropriate based on the site of origin in the medical documentation. The Primary Peritoneal Ca schema is assigned and you will need to complete the SSDIs for FIGO staging, CA-125 PreTx Interpretation, and Residual Tumor Volume Post Cytoreduction.

If the histology is 9051 or 9053 with primary site of C481, C482, or C488 for females, the Retroperitoneum schema is assigned. The only SSDI for this schema is Bone Invasion.

Self-reported information is the highest priority for coding race. That is because the race information for the U.S. population comes from census data and that information is self-reported. For national cancer statistics, in order for the numerator (cancer cases) and the denominator (population) to be comparable, use self-reported race information whenever it is available. We will add this clarification to the SEER manual.

1. You may take margin information from the operative report if it is missing from the pathology report when assigning the surgery codes for skin.

• Exception: Do not apply this to surgery codes 45-47 where specific instructions about microscopic confirmation are included

2. The rule applies to any skin malignancy for which the skin surgery codes apply.

3. SEER, CoC, NPCR, NCRA, NAACCR, and the Canadian registries participated in this decision. SEER is publishing this SINQ question for reference.

Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with low or intermediate grade dysplasia is NOT reportable.

Non-invasive mucinous cystic neoplasm (MCN) of the pancreas with high grade dysplasia is reportable. For neoplasms of the pancreas, the term MCN with high grade dysplasia replaces the term mucinous cystadenocarcinoma, non-invasive.

Code 200 derives Regional Extension (RE) for Summary Stage; however, based on the information you provided, thymus primary with mediastinal fat invasion without mediastinal pleural involvement, EOD Primary Tumor would be coded to 100: Confined to thymus (encapsulated tumor), which includes extension into the mediastinal fat; No mediastinal or pleura involvement. This derives "Localized" for Summary Stage. Per AJCC T1, extension into the mediastinal fat is separate from involvement of the mediastinal pleura.

For Summary Stage 2018, this would be code 1, Localized only (localized, NOS): Confined to thymus, NOS; No mediastinal or pleura involvement or UNKNOWN if involved.

We will note that "extension into the mediastinal fat" is included in code 100 for the next release (September 2020).

If possilbe, ask the physician(s) about the exact site of origin.

If it is not possible to obtain more information, the information in the medical documentation takes priority over ICD-O-3 Rule H, even when that results in a less specific topography code.