CTR Coding Break – Ambiguous Terminology & Cytology Nuances

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Kelsi Fryauf-Perkins

Quality Manager

The December 2023 CTR coding break topic is “Ambiguous Terminology and Cytology Nuances” The varying use of ambiguous terminology in a medical record can be a challenge while determining a diagnosis. 

The SEER and STORE manuals provide detailed guidelines of the best way to navigate these situations. The objectives for this presentation are: to learn how to use ambiguous terms and where to find them; an update for reporting cytology that contains ambiguous terminology; understanding the nuances of cytologic procedures and how to code them; as well as reviewing some coding examples. 

The 2023 SEER and STORE manuals contain the reportable ambiguous terms list and provide detailed guidelines. The guideline on using ambiguous terms on cytology was recently updated for cases diagnosed 1/1/2022 and forward. This change now allows us to use the date of the suspicious cytology as the date of diagnosis, when the diagnosis is subsequently confirmed. 

Additionally, these procedures diagnosed by cytology can be extremely nuanced in coding. They are not considered surgical and therefore not recorded in the Surgical Diagnostic and Staging Procedure. In this presentation we’ll review three coding examples that contain ambiguous terminology and cytology and review the most common coding errors for these cases. I hope this information will be helpful to CTR’s! 

Please click here if you would like to download this presentation as a PDF. 


Starting in 2024, the CTR Coding Break by Registry Partners is getting a makeover and a new name – 

PRESENTING: “Registry Partners Oncology Coding Break”

You can expect another season of our engaging Live and Recorded series, featuring top-notch educational content and speakers!

Save the date for January 18, 2024, for our first LIVE 2-hour special event on “Common Coding Errors and Misinterpretations”.  The event has been awarded 2 CEs, category A through NCRA.  

Please click here to register for our first Oncology Coding Break LIVE for 2024!