CTR Coding & Classification Systems 3 — Questions and Answers
Question 1: When a patient has two simultaneous primary tumors in the same organ, which rule governs whether they are reported as one or two cases?
- Multiple primary rules (e.g., SEER MPH rules) (Correct answer)
- AJCC staging rules
- ICD-O-3 behavior code rules
- COC accreditation standards
Correct answer: Multiple primary rules (e.g., SEER MPH rules)
SEER Multiple Primary and Histology (MPH) rules determine whether simultaneous tumors in the same organ constitute one or two reportable primaries.
Question 2: Which ICD-O-3 grade code is assigned when the pathology report states 'poorly differentiated'?
- Grade I
- Grade II
- Grade III (Correct answer)
- Grade IV
Correct answer: Grade III
Grade III (poorly differentiated) corresponds to high-grade tumors with significantly abnormal cell appearance.
Question 3: The Collaborative Stage (CS) data collection system was retired and replaced by which system beginning with cases diagnosed in 2016?
- SEER Summary Stage 2000
- AJCC TNM 7th edition manual coding
- Site-Specific Data Items (SSDIs) with AJCC 8th edition
- EOD (Extent of Disease) 2018 (Correct answer)
Correct answer: EOD (Extent of Disease) 2018
Extent of Disease (EOD) 2018 replaced Collaborative Stage for cases diagnosed on or after January 1, 2018.
Question 4: Under ICD-O-3 topography coding, C76.0 represents which primary site?
- Lymph nodes
- Head, face, and neck, NOS (Correct answer)
- Soft tissue, NOS
- Overlapping lesion of ill-defined sites
Correct answer: Head, face, and neck, NOS
C76.0 in ICD-O-3 designates the head, face, and neck as a primary site when a more specific subsite cannot be determined.
Question 5: Which histologic type does ICD-O-3 code 9732/3 represent?
- Hodgkin lymphoma
- Multiple myeloma (Correct answer)
- Acute myeloid leukemia
- Diffuse large B-cell lymphoma
Correct answer: Multiple myeloma
ICD-O-3 code 9732/3 represents multiple myeloma (plasma cell myeloma).
Question 6: When the pathology report lists 'infiltrating duct carcinoma' for a breast tumor, which ICD-O-3 histology code should the registrar assign?
- 8500/3 (Correct answer)
- 8520/3
- 8480/3
- 8140/3
Correct answer: 8500/3
Infiltrating duct carcinoma (invasive ductal carcinoma, NOS) is coded 8500/3 in ICD-O-3.
Question 7: In AJCC 8th edition staging for colorectal cancer, which N category indicates metastasis in 7 or more regional lymph nodes?
- N1a
- N1c
- N2a
- N2b (Correct answer)
Correct answer: N2b
N2b in AJCC 8th edition colorectal staging indicates metastasis in 7 or more regional lymph nodes.
CTR Coding & Classification Systems 3
When a patient has two simultaneous primary tumors in the same organ, which rule governs whether they are reported as one or two cases?