Hematopoietic and Lymphoid Neoplasm Coding Manual Effective with Cases Diagnosed 1/1/2010 and Forward Published August 2021 Editors: Jennifer Ruhl, MSHCA, RHIT, CCS, CTR, NCI SEER Margaret (Peggy) Adamo, BS, AAS, RHIT, CTR, NCI SEER Lois Dickie, CTR, NCI SEER Serban Negoita, MD, PhD, CTR, NCI SEER Suggested citation: Ruhl J, Adamo M, Dickie L., Negoita, S. (August 2021). Hematopoietic and Lymphoid Neoplasm Coding Manual. National Cancer Institute, Bethesda, MD, 2021. Hematopoietic and Lymphoid Neoplasm Coding Manual 1 In Appreciation NCI SEER gratefully acknowledges the dedicated work of Drs, Charles Platz and Graca Dores since the inception of the Hematopoietic project. They continue to provide support. We deeply appreciate their willingness to serve as advisors for the rules within this manual. The quality of this Hematopoietic project is directly related to their commitment. NCI SEER would also like to acknowledge the following individuals who provided input on the manual and/or the database. Their contributions are greatly appreciated. • Carolyn Callaghan, CTR (SEER Seattle Registry) • Tiffany Janes, CTR (SEER Seattle Registry) We would also like to give a special thanks to the following individuals at Information Management Services, Inc. (IMS) who provide us with document support and web development. • Suzanne Adams, BS, CTR • Ginger Carter, BA • Sean Brennan, BS • Paul Stephenson, BS • Jacob Tomlinson, BS Hematopoietic and Lymphoid Neoplasm Coding Manual 2 Dedication The Hematopoietic and Lymphoid Neoplasm Coding Manual (Heme manual) and the companion Hematopoietic and Lymphoid Neoplasm Database (Heme DB) are dedicated to the hard-working cancer registrars across the world who meticulously identify, abstract, and code cancer data. Cancer registrars are the foundation for statewide, provincial, territorial, national, and international cancer surveillance programs which support cancer prevention and cancer control efforts worldwide. Education SEER*Educate provides training on how to use the Heme Manual and DB. Step-by-step instructions are provided for each case scenario to learn how to use the application and manual to arrive at the answer provided. Hematopoietic and Lymphoid Neoplasm Coding Manual 3 Use this manual and the corresponding database to abstract and code cases diagnosed January 1, 2010 and forward. Some information for cases diagnosed prior to 2010 is also provided to assist registrars in coding those cases and in making multiple primary decisions. These rules are for cancer registries and are not followed by physicians. Follow the rules stated in this manual and abstract the number of primaries based on the rules. This may, or may not, agree with what the physician indicates in the patient record. However, physician interpretation can sometimes factor into determining reportability, diagnostic confirmation, or primary site; this is addressed in the specific coding instructions for those sections. Hematopoietic Comparison Documents Starting January 1, 2014, only one database for diagnosis years 2010 and forward is available and is referred to as the “Hematopoietic and Lymphoid Neoplasm Database.” The consolidated manual and database include changes from 2010, 2012 and 2014. Earlier versions (2010 and 2012) are no longer available. Comparison documents have been developed to identify the differences between the 2010, 2012 and 2014 changes of the Hematopoietic manual and database. These documents are meant to be a guide for registrars on how their data may have changed over time. Included with the rules is a column that comments on possible changes to incidence. Most of the changes will not affect incidence. There is an explanation of how and what to review where incidence may be affected. The documents can be found at: http://www.seer.cancer.gov/tools/heme/comparison.html Versions 2010 Hematopoietic Coding Manual and Database (Effective dates 1/1/2010-12/31/2011) • Release date: March 2010, Version 1.4 (initial release) • Release date: April 2010, Version 1.5 • Release date: June 2010, Version 1.6 2012 Hematopoietic Coding Manual and Database (Effective dates 1/1/2012-12/31/2013) • Release date: May 4, 2012, Version 2.1 • Release date: May 23, 2012, Version 2.1 • Release date: February 25, 2013, Version 2.2 Hematopoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: January 2014 Hematopoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: January 2015 Hematopoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: May 2018 Hematopoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: January 2019 Hematopoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: September 2020 Hematpoietic and Lymphoid Neoplasm Coding Manual (Effective 1/1/2010) • Release date: August 2021 Hematopoietic and Lymphoid Neoplasm Coding Manual 4 Contents Revision History ....................................................................................................................................................................................................................................... 8 Introduction and Background ................................................................................................................................................................................................................ 11 Leukemias and Lymphomas ............................................................................................................................................................................................................... 13 Lymphoma .......................................................................................................................................................................................................................................... 13 Myeloid neoplasms ............................................................................................................................................................................................................................ 14 The Hematopoietic Database (Heme DB) .............................................................................................................................................................................................. 16 Coding Diagnostic Confirmation (NAACCR Item #490) .......................................................................................................................................................................... 17 Transformations: Chronic Neoplasms and Acute Neoplasms ................................................................................................................................................................ 22 Steps for Using the Heme DB and Hematopoietic Coding Manual ....................................................................................................................................................... 23 First Course of Treatment for Hematopoietic Neoplasms ...................................................................................................................................................................... 25 Reporting Phlebotomy, Blood-Thinners/Anti-Clotting Medications, and Transfusions as Other Therapy (NAACCR Item #1420) ....................................................... 26 Case Reportability Instructions .............................................................................................................................................................................................................. 27 Multiple Primary Rules ........................................................................................................................................................................................................................... 29 Primary Site Coding Instructions ............................................................................................................................................................................................................ 35 Histology Coding Instructions ................................................................................................................................................................................................................ 41 Primary Site and Histology Coding Rules ............................................................................................................................................................................................... 43 Module 1: Post-Transplant Lymphoproliferative Disorder (PTLD) PH1 (2010-2020 for PTLD only) .................................................................................................. 43 Post-transplant lymphoproliferative disorder with accompanying lymphoma or plasmacytoma/myeloma ............................................................................ 43 Module 2: Plasmacytomas PH2 – PH4 ............................................................................................................................................................................................... 44 Extraosseous plasmacytoma (9734/3) ....................................................................................................................................................................................... 44 Solitary plasmacytoma of bone (9731/3) ..................................................................................................................................................................................