California Cancer Reporting System Standards, Volume III

IF361: Seq Num--Hosp, Primary Site, Morph ICD03

Owner

CoC

Edit Sets

California Hospital Transmit

Eureka Admission Level

FIELDS

Histologic Type ICD-O-3  [NAACCR #522]

Over-ride HospSeq Site  [NAACCR #1988]

Sequence Number--Hospital  [NAACCR #560]

Primary Site:  [NAACCR #400]

TABLE

N/A

Message

1.    IF 361: Conflict among Sequence Number--Hospital [value], Primary Site [value], Histologic Type ICD-O-3 [value], and Over-ride HospSeq Site [value]

Specification

This edit is skipped if the following conditions are true:

1. Histologic Type ICD-0-3 is empty.

2.    Sequence Number--Hospital is in the range of 60-88 (state registry- required/cancer committee-required)

Multiple primaries require review for a person for whom the site or histology is ill-defined or unspecified.

If the case has been reviewed and accepted as coded (Over-ride HospSeq/Site = 1), no further editing is performed.

If Sequence Number--Hospital indicates the person has had more than one primary (>00), then any case with one of the following Primary Site/Histologic Type ICD-O-3 combinations requires review:

1. C760-C768 (Ill-defined sites) or C809 (unknown primary) and Histologic Type ICD-O-3 < 9590

2. C770-C779 (lymph nodes) and Histologic Type ICD-O-3 not in range 9590-9729, 9735-9738, 9811-9818, 9823, 9827, 9837

3.    C420-C424 and Histologic Type ICD-O-3 not in range 9590-9992

4.    Any site code and Histologic Type ICD-O-3 9740-9758.

Additional Information:

This edit forces review of multiple primary cancers when one of the primaries is coded to a site-morphology combination that could indicate a metastatic site rather than a primary site.

General

It is important to verify that the suspect case is indeed a separate primary from any others that may have been reported for the patient. Correction of errors may require inspection of the abstracted text, either online or as recorded on a paper abstract. Review of the original medical record may be necessary. If the suspect case is accurate as coded, and the number of primaries is correct, set the Over-ride HospSeq/Site flag to 1 so that the case will not be considered in error when the edit is run again. It is not necessary to set the over-ride flag on the patient's other primary cancers.

If it turns out that the suspect cancer is considered a manifestation of one of the patient's other cancers, delete the former case, resequence remaining cases, and correct the coding on the latter case as necessary.

Specific Guidelines

1. Ill-defined sites (C76.0 - C76.8) or unknown primary (C80.9) and histology code less than 9590:  Look for evidence that the unknown or ill-defined primary is a secondary site (extension or metastasis) from one of the patient's other cancers. For example, a clinical discharge diagnosis of "abdominal carcinomatosis" may be attributable to the patient's primary ovarian carcinoma known to the registry, and should not be entered as a second primary.

2. Lymph nodes (C77.0-C77.9) and histology code not in the range 9590-9729:  Primary malignancies of lymph nodes are almost exclusively the lymphomas coded in the range 9590-9729. A carcinoma, sarcoma, leukemia, or other diagnosis outside that range in a lymph node is most likely a metastatic (secondary) lesion. Check whether the lymph node lesion could be a manifestation of one of the patient's other cancers. If the lesion in the lymph node is considered a separate primary, try to ascertain a more appropriate primary site than lymph nodes.

3. Hematopoietic and reticuloendothelial systems (C42.0-C42.4) and histology not in the range 9590-9989:  Primary cancers of the blood, bone marrow, spleen, etc. are almost exclusively lymphomas, leukemias, and related conditions coded in the range 9590-9989. A carcinoma, sarcoma, or other diagnosis outside that range in one of these sites is most likely a metastatic (secondary) lesion. Check whether the lesion could be a manifestation of one of the patient's other cancers. If the lesion is considered a separate primary, try to ascertain a more appropriate primary site other than those in the C42 group.

4. Other lymphoreticular neoplasms and mast cell tumors of any site (histologies 9740-9758):  Verify that these diagnoses are coded correctly and are indeed separate primaries from the other reported ones.

Example:

SITE HISTOLOGIC TYPE

SEQ. NUM. 01 RECTUM, C20.9 ADENOCA, 8140/3

SEQ. NUM. 02 PRIMARY UNK., C80.9 ADENOCA, 8140/3

The edit identifies the primary unknown case above (number 02) as a case requiring review. When the patient's chart is reviewed again, it is determined that the diagnosis was based on a liver biopsy showing metastatic adenocarcinoma, and the patient has known liver metastases from his rectal CA.  Delete case number 02, and change the sequence number of the rectal cancer to 00.  Check carefully for any demographic, diagnostic, staging, treatment, or follow-up information recorded on the primary unknown abstract that should be added to the rectal cancer case.

Historical Changes: