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Multiple Primary and Histology Coding Exercises
Case #1
Patient has a right colon resection after a polyp with invasive carcinoma
was found on a screening colonoscopy.
Pathology report reads:
Final Diagnosis:
Tumor Site: Ascending colon.
Histologic type: Adenocarcinoma arising in a villous adenoma.
How many primaries?
Which rule?
What is the histology?
Which rule?
Case #2
Patient has a left hemicolectomy for a colon cancer that was found on
colonoscopy.
Pathology report reads:
Tumor #1:
Tumor Site: Transverse colon.
Histologic type: Adenocarcinoma.
Tumor #2:
Tumor Site: Descending colon.
Histologic type: Adenocarcinoma.
How many Primaries?
Which rule?
What is the Histology?
Which rule?
KCR Abstractor’s Training
February 10-12, 2016
Presented By: Nicole Catlett, CTR
Case #3
Patient has a right hemicolectomy performed after a cancer was found on
colonoscopy.
The pathology report reads:
Tumor #1
Tumor site: Ascending colon
Histologic type: Invasive Adenocarcinoma arising in a tubulovillous adenoma.
Extent: Invasion of muscularis propria. pT2
Tumor #2
Tumor site: Ascending colon
Histologic type: Invasive Adenocarcinoma.
Extent: Invasion through bowel wall into pericolic fat. pT3.
How many primaries?
Which rule?
What is Histology?
Which rule?
Case #4
Patient has a colonoscopy where multiple polyps are seen in the left colon.
Patient then has a left hemicolectomy.
The pathology report reads:
Tumor #1
Tumor Site: Descending colon.
Histologic type:
Tubulovillous adenoma with invasive adenocarcinoma present.
Tumor #2
Tumor Site: Descending colon.
Histologic type: Adenomatous polyp with focus of invasive adenocarcinoma.
How many primaries?
Which rule?
What is Histology?
Which rule?
KCR Abstractor’s Training
February 10-12, 2016
Presented By: Nicole Catlett, CTR
Case #5
Patient has a history of Adenocarcinoma of Transverse Colon diagnosed
5 years ago s/p segmental resection. The patient now has been
diagnosed with invasive mucinous adenocarcinoma in the Sigmoid
colon.
How many primaries?
Which rule?
What is the Histology?
Which rule?
Case #6
Patient has history of Ascending Colon Adenocarcinoma that was
diagnosed 3 years ago s/p segmental resection. The patient now has
Adenocarcinoma with signet ring features found at the anastomotic
site. The pathology report does not state the percentage of signet ring
adenocarcinoma anywhere on the report.
How many primaries?
Which Rule?
What is histology?
Which rule?
KCR Abstractor’s Training
February 10-12, 2016
Presented By: Nicole Catlett, CTR
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