Colon

  • Multiple tumors/polyps
    Which ones should be counted independently and which ones are part of the same disease process? When a polyp is biopsied and the resection shows residual, plain adenocarcinoma in the same area, what histology histology code is the best to use?
  • Contiguous/overlapping sites
    Tumors at the rectosigmoid junction and ileocecal valve have long been a problem
  • Time between diagnoses
    For a patient with multiple colon polyps, is timing a factor in making the diagnosis?
  • NOS versus specific histology
    Pathologists have specific criteria for diagnosing certain colon malignancies that are not understood by most registrars. Clearer definitions and criteria for coding are needed for:
    • Mucinous adenocarcinoma
    • Neuroendocrine carcinoma
    • Signet ring cell adenocarcinoma
    • Undifferentiated carcinoma
  • Adenocarcinoma, NOS
    A very common diagnosis for colon; are there indications in the pathology report that a more specific diagnosis is warranted?
  • Adenocarcinoma with mixed subtypes
    Are there specific histologies that comprise this diagnosis for colon cancer?