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California Cancer Registry Volume I: Data Standards and Data Dictionary Source: Cancer Reporting in California: Abstracting and Coding Procedures for Hospitals (California Cancer Reporting System Standards, Vol. I), updated May 2007 |
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California Cancer Registry Volume I: Data Standards and Data Dictionary Source: Cancer Reporting in California: Abstracting and Coding Procedures for Hospitals (California Cancer Reporting System Standards, Vol. I), updated May 2007 |
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DSQC #2005-01
CLARIFICATION
EFFECTIVE: Cases Diagnosed January 1, 2004 Forward
The attached document includes clarifications in coding and abstracting instructions resulting from the 2004 Data Changes Training. Although this clarification is effective with cases diagnosed January 1, 2004 forward, it is not necessary to go back and recode cases that have already been abstracted or transmitted.
Please refer to this document for assistance when abstracting.
1. Question: What diagnosis year is BBT reporting effective?
Response: Statewide reporting of BBT commenced with diagnosis year 1/01/01.
For cases diagnosed 1/01/04 forward, abstract using 2004 Data Changes rules (Vol. I, Sec. II.1.9.1 - II.1.9.7)
2. Question: How are BBT staged?
Response: For diagnosis years 2001-2003 the CCR does not require benign brain tumors to be staged; the default EOD codes are 999 99 9 99/99. If you have been assigning codes/stages to them in the past, we recommend you continue this practice.
For cases diagnosed 1/01/04 forward, use the Collaborative Staging scheme for the appropriate site. There is a schema for Brain and Cerebral Meninges, Other parts of the CNS (includes the spinal meninges, and cranial nerves), and Thymus, Adrenal Gland and Other Endocrine Glands (includes pituitary and pineal glands and craniopharyngeal duct).
3. Question: What sequence number is assigned to a second BBT?
Response: The first BBT is assigned sequence #60. If another BBT primary tumor is subsequently diagnosed, the first BBT tumor sequence is changed to #61 and the second BBT is assigned sequence #62.
Example: In 2004, a person was diagnosed with a BBT (sequence #60). In 2005, a second reportable BBT was diagnosed. The 2004 case changes to sequence #61 and the tumor diagnosed in 2005 is assigned sequence #62.
4. Question: If a BBT case is diagnosed prior to 01/01/04 and recurs in 2004, is the recurrence reportable?
Response: If the case was diagnosed prior to 1/01/01, it would not be reported. If the case was diagnosed 1/01/01 through 12/31/03, it would have been previously reported to the CCR using previous reporting rules.
5. Question: How many primaries do you abstract in the scenario below?
A patient has a known BBT diagnosed after 1/01/04 and it is not treated. After time, the patient is diagnosed with a malignant brain tumor in the same site.
Response: Report as two primaries one benign (sequence number 60) and one malignant (sequence number 00). Once a tumor transforms from benign to malignant, another abstract for the malignant tumor is prepared.
Reference: Volume I, Section II.1.9.5
6. Question: If there is one lesion in the midline of the brain, is this coded as one lesion?
Response: Yes, code as one lesion and use the code where the midline structure is listed.
Example: A midline lesion of the third ventricle would be coded to C71.5 third ventricle
7. Question: If there is one lesion in the midline of the brain and one lesion elsewhere in the brain with the same histology diagnosed at the same time, is this one primary or two?
Response: Compare the subsite code for the midline tumor to the subsite code for the other tumor. If they are different at the subsite level, abstract as two primaries. If the location of the midline tumor is in the same subsite, it would be considered one lesion.
Example: There is one tumor in the midline of the third ventricle (C71.5) and a separate tumor with the same histology within the third ventricle (C71.5). Abstract as one primary.
Example: There is one tumor in the midline of the temporal lobe (C71.2) and a separate midline tumor located in the right parietal lobe (C71.3). Abstract as two primaries.
8. Question: How do you code laterality for a lesion in the midline of the brain?
Response: Midline tumors of the CNS are sometimes coded 9 in laterality. If the lesion is midline in a single brain structure, then code 0. For example, laterality is coded 0 (not a paired organ) for C71.6, cerebellum, NOS.
9. Question: For coding a single primary brain tumor with 2 histologies, (both histologies are listed in the same histologic group, Volume I, page 31), which histology do you code?
Response: The table on page 31 of Volume I does not apply to single tumors. It only applies when there are multiple tumors. For single tumors with different histologies, follow rule 4 in Volume I, page 82, which states to use the numerically higher histology code.
10. Question: Are non-malignant blood vessel tumors occurring in the CNS sites reportable?
Response: Yes, the ICD-O-3 Primary Brain and CNS Site/Histology Listing (Appendix V in Volume I) includes blood vessel tumors under several categories including meninges C70.0-C70.9, brain C71.0-C71.4 and C71.7-C71.9, (excluding ventricle), spinal cord C72.0, cauda equina C72.1, cranial nerves C72.2-C72.5, cerebellum C71.6 and other nervous system C72.8-C72.9.
These tumors include:
9120/0 Hemangioma, NOS
9121/0 Cavernous hemangioma
9150/0 Hemangiopericytoma, benign
9150/1 Hemangiopericytoma, NOS
9161/1 Hemanioblastoma
11. Question: Should blood vessel tumors occurring in CNS sites be coded to blood vessels or CNS?
Response: They should be coded to the CNS site in which they occur.
Example: Patient is diagnosed with a hemangioblastoma of the right temporal lobe of the brain. Site code: C71.2 (temporal lobe, brain), histology code: 9161/1, Laterality: Right only
12. Question: Is laterality coded for tumors of the meninges?
Response: Code laterality for cerebral meninges (C70.0) only. Spinal meninges (C70.1) is not listed as a lateral site, thus laterality for spinal meninges is coded to 0.
Reference: Volume I, Section II.1.9.2
13. Question: Is it possible for a benign schwannoma to arise on the spinal cord or do they always arise from nerve roots coming off the cord?
Response: Anatomically they must be derived from Schwann cells which are not a part of the CNS, so they must all come from peripheral nerves, therefore, they all come from nerve roots. Thus, benign schwannomas of the spinal cord/peripheral nerves are not reportable.
14. Question: If the surgeon states "resection of intradural extramedullary schwannoma" does this mean that the tumor is outside the cord but within the dura?
Response: Yes, but it also means it is on a peripheral nerve root and therefore not reportable.
