Q:     What is the clinical and pathologic stage of a carcinoma in situ (CIS) of the breast where the pathologic criteria has been met – patient underwent a breast lumpectomy. A:     cT blank, cN0, cM0 clinical stage group 0, PTis, pN blank, pM blank pathologic stage group 0 Per AJCC general instructions page 12, carcinoma in situ is an exception to the stage grouping guidelines.  By…

Q: A patient is diagnosed with Lung cancer with findings positive of left supraclavicular lymph node metastasis. The lung tumor is located in the LUL with no further extension noted. What is the SEER Summary Stage? A: Per SEER General Summary Stage manual, involvement of supraclavicular lymph nodes, ipsilateral or contralateral is a code 7 – Distant.

Q: How do you code BCG followed by a TURB for bladder cancer? A: Per FORDS bladder surgery codes: If immunotherapy is followed by surgery of the type coded 20-80 code that surgery instead and code the immunotherapy only as immunotherapy.   Surgery code = 27 and immunotherapy code = 01   Q: A breast cancer patient has a sentinel lymph node biopsy followed by a separate…

Q:  How do we code Rituxan (Rituximab) for a 5/1/2014 diagnosis? A:  Per SEER Rx, the category is Biologic therapy (BRM, immunotherapy). As of January 1, 2013 this drug changed categories. Effective with diagnosis date 1/1/2013 and forward, code Rituxan as a BRM/Immunotherapy. For cases diagnosed prior to 1/1/2013 code as chemotherapy.