Overview: What The 2007 Rules Are

The 2007 Multiple Primary and Histology (MP/H) Coding Rules represent the first changes in nearly three decades in the way multiple primaries are counted and the first formal changes in the coding of histology in more than five years. Site-specific multiple primary and histology rules have been developed to promote consistent and standardized coding by cancer registrars.

The new, site-specific rules have been developed to address an assortment of problems that have been associated with inappropriate, ineffective, or inconsistent application of the general rules to specific cancer sites. The rules provide a major improvement in the classification, sequencing, and grouping of tumors, for which the long-established multiple primary and histology coding rules no longer work.

View the multiple primaries and histology coding rules project timeline.

The 2007 MP/H Rules provide site-specific rules for lung, breast, colon, melanoma of the skin, head and neck, kidney, renal pelvis/ureter/bladder, and malignant brain. A separate set of rules addresses both general and specific rules for malignant solid tumors originating in all other sites.

The multiple primary rules guide and standardize the process of determining the number of primaries. The histology rules contain detailed histology coding instructions. For example, there are instructions and guidance for identifying histologic lineages, differentiating between general (NOS) terms and specific histologic types, and correctly assigning mixed and combination codes.

The rules are available in three formats: flowchart, matrix and text. The different formats were developed to meet the needs of registrars who have different learning styles.

The MP/H Task Force also developed three new data items that complement these rules, Multiplicity Counter, Date of Multiple Tumors, and Type of Multiple Tumors Reported as One Primary.

Read about the history of the MPH Project committee.

View the list of participating organizations.

Many state registrars associations have presented workshops on the new rules. The rules have been presented at several national meetings, including the National Cancer Registrars Association Annual Conference, the North American Association of Central Cancer Registries Annual Conference, and the SEER Abstractors and Coders Workshop at NCRA.

The new multiple primary and histology coding rules will be implemented in 2007, effective with cases diagnosed on and after January 1. At that time the 2007 rules replace all previously published rules for cases diagnosed in 2007 and beyond. Do not use these rules to abstract cases diagnosed prior to January 1, 2007.

This web-based training module is a compilation of materials presented at various workshops and provides the most current concepts in the application of the new rules for those registrars who have not been able to attend an in-person workshop. Continuing education credit for this module is available from the National Cancer Registrars Association through Sept. 6, 2007.

This module has been approved for 4 hours of CE credit. The approval number is 2007-034. After completion of this module, please print a certificate of completion for your credit.

To use this educational module most effectively, you should have available either a printed or electronic version of the new rules. These can be downloaded from the SEER website.