Abstracting/Coding Flashcards
Clinical and Pathological Grade cannot be left blank.
True or False?
True.
Grade can only be assigned based on the primary tumor.
True or False?
True.
If tissue from the primary site is not available, you may code grade from a contiguous adjacent site.
True or False?
True
If tissue from the primary site is unavailable, and the only tissue you have is from a lymph node, the grade code MUST be _____
9 Unknown
If there are invasive and in situ components involved in the specimen, which portion should you grade?
Grade the invasive portion only.
Dysplasia is coded for grade.
True or False?
False.
If a tumor is in situ only, can you assign grade?
Yes, as long as there is no invasive component.
SBR (Scarf-Bloom-Richardson) staging system is synonymous with what other breast cancer staging system?
Nottingham.
yC and yP are left blank when…
No neoadjuvant therapy has been given.
If grade is not documented anywhere in the patient’s records, what is the grade code should you use?
9 Unknown
If you don’t know if a documented grade is clinical or pathological, how do you code the grade?
Enter the documented grade as the Clinical grade, and enter 9 Unknown as the Pathological grade.
If a patient has neoadjuvant treatment prior to resection of the tumor, the Pathological grade MUST be ____
9 Unknown
The pathology results of a TURP can only be used for
A. Pathological grade.
B. Clinical grade.
C. Post-therapy grade.
D. Both A and B.
B. Clinical grade.
A free online application that has full copies of the STORE manual, Collaborative Staging, Multiple Primary and Histology coding manuals, the NAACCR data dictionary, the SEER manual and the intro and histology section of the ICD-O-3 is called ____
Registry Plus Online
How many digits are in SEER’s Extent of Disease coding system?
10
Combination codes such as 8523/3 (infiltrating duct mixed with other types of carcinoma) and 8524/3 (infiltrating lobular mixed with other types of carcinoma) are used when
A. Two types of carcinomas are intermixed within one tumor.
B. Two tumors exist in the same primary site - one tumor is infiltrating ductal and the other tumor is infiltrating lobular.
C. Two tumors with the different histologies “overlap” each other (collision tumors).
D. None of the above
A. Two types of carcinomas are intermixed within one tumor.
Which term is used by pathologists to describe a group of cells that can be seen only by a microscope?
A. Focal tumor
B. Tumor focus
C. Overlapping tumor
D. Contiguous tumor
B. Tumor focus
The Solid Tumor Rules state that when there is more than one pathology report, use the report from the most representative specimen. The most representative specimen is
A. The specimen from the most extensive surgery.
B. The specimen with the most specific diagnosis.
C. The specimen with the greatest amount of tumor.
D. None of the above
C. The specimen with the greatest amount of tumor.
How many main stage groups exist in the Summary Staging classification system?
A. 3
B. 4
C. 5
D. 9
C. 5
Which tumor marker is commonly used to determine whether specific targeted therapy is appropriate for colorectal cancer?
A. AFP
B. CA-125
C. ER/PR
D. KRAS mutation analysis
D. KRAS mutation analysis
Which tumor marker is used to predict response to therapy for cutaneous melanoma and colorectal cancer?
A. ALK gene rearrangements
B. BRAF mutation V600E
C. CD20
D. EGFR mutation analysis
B. BRAF mutation V600E
Prednisone is considered a
A. Hormone.
B. Adrenocorticoid.
C. Immunotherapy.
D. Both (a) and (b)
D. Both (a) and (b)
Radiofrequency ablation is a type of treatment that uses
A. Heat energy.
B. Ultraviolet light.
C. Radioactive rays.
D. Specialized radio wave
A. Heat energy.
What type of transplant involves the transplant of cells from the body of the transplant recipient?
A. Allogeneic transplant
B. Syngeneic transplant
C. Cord blood
D. Autologous
D. Autologous
Approximately what percentage of cancer cases are confirmed following the gross and microscopic examination of organs, tissues, cells, and bodily fluids removed from patients?
A. 75
B. 85
C. 95
D. 100
C. 95
Which statement(s) is true regarding the Solid Tumor Rules?
A. If there is bilateral involvement, assume the patient has multiple primaries.
B. When a tumor has separate microscopic foci, ignore the foci and use the “Single Tumor” module.
C. Both (a) and (b)
B. When a tumor has separate microscopic foci, ignore the foci and use the “Single Tumor” module.
The 2007 MP/H Rules are only to be used for cases diagnosed 1/1/2007 through 12/31/2017. From 1/1/2018 forward, the Solid Tumor Rules are used.
True or False?
True
Which tumor marker is commonly used to assess stage, prognosis and response to treatment for choriocarcinoma and testicular cancer?
A. Beta-hCG
B. HER2/neu
C. LDH
D. None of the above
A. Beta-hCG
Which tumor marker is used to help diagnose multiple myeloma?
A. BCR-ABL fusion gene
B. Immunoglobulins
C. CgA
D. CEA
B. Immunoglobulins
What type of agents enhance the effects of cancer-directed treatment but do not directly affect the cancer?
A. Immunotherapy
B. Chemotherapy
C. Hormonal therapy
D. Ancillary drugs
D. Ancillary drugs
What reference is used by registrars in North America to determine the number of primaries to report for a patient?
A, International Agency for Research on Cancer’s (IARC) Multiple Primary Rules Guide
B. Surveillance, Epidemiology, and End Results Program (SEER) Program Coding Manual
C. Commission on Cancer (CoC) FORDS Manual
D. SEER Multiple Primary and Histology Coding Rules
D. SEER Multiple Primary and Histology Coding Rules
When abstracting a case, the first step is to
A. Review the site-specific multiple primary rules.
B. Determine the primary site(s) by reading the medical record.
C. Read the site-specific Equivalent Terms and Definitions.
D. None of the above
B. Determine the primary site(s) by reading the medical record.
What factor(s) is used to determine stage for the majority of malignancies?
A. Location of the original tumor
B. Whether or not the cancer spread to distant areas in the body
C. The class of case
D. Both (a) and (b)
D. Both (a) and (b)
What is the prefix used in the AJCC TNM staging system that indicates the stage was determined at autopsy?
A. c
B. p
C. r
D. a
D. a
What is the general AJCC staging guideline when the clinician cannot decide between two stages for a single disease process?
A. Assign the lower (lesser) stage.
B. Assign the higher (greater) stage.
C. Assign an unknown stage for only solid tumors.
D. Assign an unknown stage for all primaries.
A. Assign the lower (lesser) stage.
Which tumor marker is used to determine whether treatment with trastuzumab (Herceptin) is appropriate?
A. Beta-hCG
B. LDH
C. PSA
D. HER2/neu
D. HER2/neu
Which tumor marker is commonly used to confirm the diagnosis of chronic myeloid leukemia?
A. Immunoglobulins
B. CgA
C. CEA
D. BCR-ABL fusion gene
D. BCR-ABL fusion gene
Herceptin is coded as
A. Chemotherapy.
B. Immunotherapy.
C. Hormonal therapy.
D. Radiotherapy.
B. Immunotherapy.
What resource is used to determine the number of primaries to be accessioned by the registrar?
The Solid Tumor Rules
The ICD-O-2 and ICD-O-3 topography codes are based on
A. ICD-9.
B. ICD-9-CM.
C. ICD-10
D. None of the above.
C. ICD-10
Per the Multiple Primary and Solid Tumor rules, recurrence is defined as
A. The reappearance of disease that was thought to be cured or inactive.
B. A new occurrence of cancer arising from cells that have nothing to do with the earlier (first) cancer.
C. The spread of a previously diagnosed cancer to a distant site.
D. Both A and B.
D. Both A and B.
Per the Solid Tumor Rules, when counting the number of primary tumors described in the medical record do not count
A. Metastatic lesions.
B. Microscopic tumor foci.
C. Tumors described as likely to be malignant.
D. Both (a) and (b)
D. Both (a) and (b)
What factor(s) is used to determine stage for brain and spinal cord malignancies?
A. Location of the tumor
B. Size of the tumor
C. Grade and cell type of the tumor
D. None of the above
C. Grade and cell type of the tumor
What does the code TX mean in the TNM staging system?
A. There is no evidence of a primary tumor.
B. Tumor has not spread to neighboring tissues.
C. Tumor is noninfiltrating.
D. Tumor cannot be evaluated.
D. Tumor cannot be evaluated.
Which tumor marker is commonly used as part of the work-up for liver primaries?
A. AFP
B. CA-125
C. ER/PR
D. KRAS mutation analysis
A. AFP
Which tumor marker is used to determine whether treatment with a targeted therapy is appropriate for non-Hodgkin lymphoma?
A. ALK gene rearrangements
B. BRAF mutation V600E
C. CD20
D. EGFR mutation analysis
C. CD20
What staging system(s) is considered to have clinical relevance?
A. AJCC TNM Stage
B. Summary Stage
C. Both (a) and (b)
D. Neither (a) nor (b)
A. AJCC TNM Stage
For papillary and/or follicular thyroid cancer patients treated surgically, Levothyroxine is coded as
A. Chemotherapy.
B. Immunotherapy.
C. Hormone therapy.
D. Biologic therapy
C. Hormone therapy.
Physical therapy is considered a
A. Alternative therapy.
B. Complementary therapy.
C. Neoadjuvant therapy.
D. Support service.
D. Support service.
Brachytherapy is given
A. Orally.
B. Intracavitarily.
C. Intraperitoneally.
D. Externally.
B. Intracavitarily.
Antiandrogens are primarily used to treat
A. Metastatic testicular cancer
B. Metastatic prostate cancer
C. Both (a) and (b)
D. Neither (a) nor (b)
B. Metastatic prostate cancer
Are sentinel lymph nodes included in the Regional Lymph Nodes Examined and Regional Lymph Nodes positive fields?
Yes.
The Regional Lymph Nodes Examined and Regional Lymph Nodes Positive fields are cumulative fields and should include all lymph nodes removed through the completion of the first course of treatment.
True or False?
True
If the primary tumor cannot be found, and a patient is diagnosed through biopsy of a regional lymph node, how do you code the size of the primary tumor?
000
If the patient has neoadjuvant therapy prior to surgery, how do you code the pathological tumor size?
999
If there is missing TNM information, what is the code for stage?
You cannot assign stage with missing TNM information.
If a tumor size is given as between two sizes, such as 10-12 cm, how do you code the size?
Record the size as the midpoint of the two sizes given.
If there are discrepancies in the stated size of the tumor in the clinical workup, how do you code the clinical size?
Record the largest stated size of the tumor from the physical exams and imaging reports.
What is recorded in the Tumor Size Summary field?
The most accurate measurements of a solid primary tumor, usually from the surgical specimen.
For breast tumors only, how do you code tumor sizes between 1.1 mm and 2.4 mm?
Round them up or down to 2 mm
Presurgical embolization of hypervascular tumors with particles, coils, or alcohol is typically performed to make resection of the tumor easier, and is not coded.
True or False?
True
An intra-axial mass is located in the ______
Brain
The hematopoietic and lymphoid neoplasm rules went into effect for cases diagnosed
A. January 1, 2007 and after
B. January 1, 2009 and after
C. January 1, 2010 and after
D. January 1, 2012 and after
C. January 1, 2010 and after
Classification of the extent of disease is known as _____
Staging
The pathology report of a radical mastectomy is reported as infiltrating ducal carcinoma with cancer at the nipple, 6:00, 9:00, and 12:00. How many primaries are there?
A. One
B. Two
C. Three
D. Four
A. One
The date of diagnosis for an autopsy only case is
A. Date of death
B. Date the tissue was examined
C. Date of autopsy
D. None of the above
A. Date of death
What surgical procedure MUST be performed in order to qualify for assignment of pathological TNM for cancer of the prostate?
A total prostatectomy.
The 2018 Solid Tumor Rules are based on the WHO Classification of Tumors, which are also known as the _____ books.
Blue
The 2007 Multiple Primary and Histology (MPH) Coding Rules have been revised and are now referred to as the ______
2018 Solid Tumor Rules
Biomarkers can be used to determine multiple primaries.
True or False?
False.
What is the current preferred term for duct or ductal carcinoma of the breast?
Carcinoma NST
Subtypes, variants, architecture, pattern, and features of DCIS or Carcinoma NST of the breast ______
A. Are coded.
B. Are not coded.
B. Are not coded.