California Cancer Reporting System Standards Volume I: Abstracting and Coding Procedures
Refer to the most current Multiple Primary and Histology Coding Rules for solid tumor coding instructions. This applies to cases diagnosed January 1, 2007 and forward.
Refer to the most current Hematopoietic and Lymphoid Database and the Hematopoietic & Lymphoid Neoplasm Coding Manual for Hematopoietic and Lymphoma coding instructions. This applies to cases diagnosed January 1, 2010 and forward.
Melanoma
If the primary site is unknown, assume the primary site is the skin and enter C44.9.
Unless it is stated to be a recurrent or metastatic melanoma, record each melanoma as a separate primary when any of the following apply:
The occurrences are more than two months apart
The fourth character of the ICD-O topography code for skin (C44._) is different
The first three digits of the ICD-O-3 morphology code are different
An in situ melanoma is followed by an invasive melanoma
The occurrences are within the same sub-site code, but different lateralities or different trunk sides, such as chest and back
Kaposi's Sarcoma
Code the primary site as the site in which the tumor arises. If Kaposi's sarcoma arises in the skin and another site simultaneously, or if no primary site is stated, code the primary site as skin (C44._).
BREAST:
Subareolar/Retroareolar Tumor
Code as the central portion of the breast (C50.1), which indicates that the tumor arose in the breast tissue beneath the nipple, but not in the nipple itself.
Ductal and Lobular Breast Lesions
See Section II.1.3.4 for a discussion of certain mixed ductal and lobular lesions of the female breast. If these lesions occur in different quadrants of the same breast, the site code is C50.9.
COLON:
Determining Subsite
If there is no other information given regarding subsite except for the measurement given in the colonoscopy, the measurement may be used to assign subsite. If the colonoscopy measurement is used to assign a specific subsite, the CCR’s standard reference is the colon diagram:
AJCC Cancer Staging Atlas, Second Edition
If there is conflicting information in the medical record with regard to subsite and there is no surgical resection, code the subsite as stated by the physician. If there is a surgical resection, code the subsite as stated in the operative report or a combination of the operative report and the pathology report.
Familial Polyposis
When multiple carcinomas arising in familial polyposis involve multiple segments of the colon or the colon and rectum, code the primary site as colon, NOS (C18.9).
OTHER:
Neuroblastoma
Code neuroblastomas of ill-defined sites for the most likely site in each case. (Adrenal medulla is a common site). If the location of the primary tumor is unknown, code as connective, subcutaneous, and other soft tissue, NOS (C49.9).