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Organization | Field Name | ID | Required |
|---|---|---|---|
KCR | Histology (Histology) | 30090 | yes |
NAACCR | Histologic Type ICD-O-3 | yes |
Field Length: 4
Instructions for Coding
Record histology using the ICD-O-3 codes in the Numeric Lists/Morphology section (ICD-O-3, pp. 69-104) and in the Alphabetic Index (ICD-O-3, pp. 105-218).
Follow the coding rules outlined on pages 20 through 40 of ICD-O-3.
Use the SEER 2007 Multiple Primary and Histology Coding Rules when coding the histology for reportable solid malignant tumors. These rules are effective for cases diagnosed January 1, 2007, or later. Do not use these rules to abstract cases diagnosed prior to this date; for these cases, see the section below entitled "Rules for Coding Histology Prior to 2007."
Use the Hematopoietic and Lymphoid Neoplasm Case Reportability and Coding Manual and the Hematopoietic Database when coding histology for reportable hematopoietic and lymphoid malignancies diagnosed January 1, 2010 onward. NOTE: The Hematopoietic Database contains additional histologies which are not found in ICD-O-3, but are valid for use from 2010 forward.
Review all pathology reports.
Code the final pathologic diagnosis.
EXCEPTION: If the final diagnosis is "Not Otherwise Specified" (carcinoma, NOS; melanoma, NOS; sarcoma, NOS; lymphoma, NOS; or malignant tumor, NOS), then code the histology from the microscopic description or comment if it identifies a more specific histologic type (higher ICD-O-3 code) such as adenocarcinoma, amelanotic melanoma, or spindle cell sarcoma.
The codes for cancer, NOS (8000) and carcinoma, NOS (8010) are not interchangeable. If the physician says that the patient has carcinoma, then code carcinoma, NOS (8010).
Note that the determination of multiple primaries for benign and borderline intracranial and CNS tumors is based on histologic groupings. See the table and rules below for histologic groupings for non-malignant brain and CNS tumors.
See Table of Specific Histologies that should not be coded to ill-defined sites (C76._).
Rules for Coding the Histology of Solid Tumors Diagnosed Prior to 2007
Coding Instructions
Use all of the information for a single primary to code the histology.
1. If there is no tumor specimen, code the histology described by the medical practitioner.
2. Use the histology stated in the final diagnosis from the pathology report. Use the pathology from the procedure that resected the majority of the primary tumor.
If a more specific histologic type is definitively described in the microscopic portion of the pathology report or the comment, code the more specific diagnosis.
3. Cases reported to KCR cannot have a metastatic (/6) behavior code. If the only pathology specimen is from a metastatic site, code the appropriate histology code and the malignant behavior code /3. The primary site and its metastatic site(s) have the same basic histology.
Histology Coding Rules for Single Tumor
· The rules are in hierarchical order. Rule 1 has the highest priority.
· Use the rules in priority order.
· Use the first rule that applies to the case. (Do not apply any additional rules.)
1. Code the histology if only one type is mentioned in the pathology report.
2. Code the invasive histology when both invasive and in situ tumor are present.
Example: Pathology report reads infiltrating ductal carcinoma and cribriform ductal carcinoma insitu. Code the invasive histology 8500/3.
Exception: If the histology of the invasive component is an 'NOS' term (e.g., carcinoma, adenocarcinoma, melanoma, sarcoma), then code the histology of the specific term associated with the insitu component and an invasive behavior code.
3. Use a mixed histology code if one exists
Examples of mixed codes: (This is not a complete list, these are examples only)
8490 Mixed tumor, NOS
9085 Mixed germ cell tumor
8855 Mixed liposarcoma
8990 Mixed mesenchymal sarcoma
8951 Mixed mesodermal tumor
8950 Mixed Müllerian tumor
9362 Mixed pineal tumor
8940 Mixed salivary gland tumor, NOS
9081 Teratocarcinoma, mixed embryonal carcinoma and teratoma
4. Use a combination histology code if one exists
Examples of combination codes: (This is not a complete list; these are examples only)
8255 Renal cell carcinoma, mixed clear cell and chromophobe types
8523 Infiltrating duct carcinoma mixed with other types of carcinoma
8524 Infiltrating lobular carcinoma mixed with other types of carcinoma
8560 Adenosquamous carcinoma
8045 Combined small cell carcinoma, combined small cell-large cell
5. Code the more specific term when one of the terms is 'NOS' and the other is a more specific description of the same histology.
Example 1: Pathology report reads poorly differentiated carcinoma, probably
squamous in origin. Code the histology as squamous cell carcinoma rather than the non-specific term "carcinoma."
Example 2: The pathology report from a nephrectomy reads renal cell carcinoma (8312) (renal cell identifies the affected organ system rather than the histologic cell type) in one portion of the report and clear cell carcinoma (8310) (a histologic cell type) in another section of the report. Code clear cell carcinoma (8310); renal cell carcinoma (8312) refers to the renal system rather than the cell type, so renal cell is the less specific code.
6. Code the majority of tumor.
a. Based on the pathology report description of the tumor.
b. Based on the use of majority terms. See definition for majority terms.
...
Terms that mean the majority of tumor
...
Terms that DO NOT mean the majority of tumor
...
Predominantly
...
With foci of
...
With features of
...
Focus of/focal
...
Major
...
Areas of
...
Type1
...
Elements of
...
With.....Differentiation1
...
Component1
...
Pattern (Only if written in College of American Pathologists [CAP] Protocol)2
...
Architecture (Only if written in College of American Pathologists [CAP] Protocol)2
Note: Examples of CAP protocols for specific primary sites may be found on the website:
7. Code the numerically higher ICD-O-3 code. This is the rule with the lowest priority and should be used infrequently.
Histology Coding Rules for Multiple Tumors with Different Behaviors in Same Organ Reported as a Single Primary
1. Code the histology of the invasive tumor when one lesion is in situ (/2) and the other is invasive (/3).
Example: At mastectomy for removal of a 2 cm invasive ductal carcinoma, an additional 5 cm area of intraductal carcinoma was noted. Code histology and behavior as invasive ductal carcinoma (8500/3).
Histology Coding Rules for Multiple Tumors in Same Organ Reported as a Single Primary
1. Code the histology when multiple tumors have the same histology.
2. Code the histology to adenocarcinoma (8140/_; in situ or invasive) when there is an adenocarcinoma and an adenocarcinoma in a polyp (8210/_, 8261/_, 8263/) in the same segment of the colon or rectum.
3. Code the histology to carcinoma (8010/_; in situ or invasive) when there is a carcinoma and a carcinoma in a polyp (8210/_) in the same segment of the colon or rectum.
4. Use a combination code for the following:
a. Bladder: Papillary and urothelial (transitional cell) carcinoma (8130)
b. Breast: Paget Disease and duct carcinoma (8541)
c. Breast: Duct carcinoma and lobular carcinoma (8522)
d. Thyroid: Follicular and papillary carcinoma (8340)
5. Code the more specific term when one of the terms is 'NOS' and the other is a more specific description of the same histology.
6. Code all other multiple tumors with different histologies as multiple primaries.
Histologic groupings to determine same histology for non-malignant brain tumors
When there are multiple tumors, use the following table to determine if the tumors are the same histology or different histologies.
...
Histologic Group
...
ICD-O-3
...
Choroid plexus neoplasm
...
9390/0, 9390/1
...
Ependymoma
...
9383, 9394, 9444
...
Neuronal and neuronal-glial neoplasm
...
9384, 9412, 9413, 9442, 9505, 9506
...
Neurofibroma
...
9540/0, 9540/1, 9541, 9550, 9560
...
Neurinomatosis
...
9560
...
Neurothekeoma
...
9562
...
Neuroma
...
9570
...
Perineurioma, NOS
...
9571
Rules for Using Histologic Group Table for Non-Malignant Brain Tumors
1. If both histologies are listed in the table, then
a. Histologies that are in the same grouping or row in the table are the same histology.
Note: Histologies that are in the same grouping are a progression, differentiation or subtype of a single histologic category.
b. Histologies listed in different groupings (or rows) in the table are different histologies
2. If one or both of the histologies is not listed in the table, then
a. If the ICD-O-3 codes for both histologies have the identical first three digits, the histologies are the same.
b. If the first three digits of the ICD-O-3 histology code are different, the histology types are different.
Specific Histologies with Ill-Defined Sites
If any of the following histologies appears only with an ill-defined site description (e.g., "abdominal" or "arm"), code it to the tissue in which such tumors arise rather than the ill-defined region (C76._) of the body, which contains multiple tissues.
...
Histology
...
Description
...
Code to this Site
...
8720-8790
...
Melanoma
...
C44._, Skin
...
8800-8811, 8813-8830,
8840-8921, 9040-9044
...
Sarcoma except periosteal fibrosarcoma and dermatofibrosarcoma
...
C49._, Connective, Subcutaneous and Other Soft Tissues
...
8990-8991
...
Mesenchymoma
...
C49._, Connective, Subcutaneous and Other Soft Tissues
...
9120-9170
...
Blood vessel tumors, lymphatic vessel tumors
...
C49._, Connective, Subcutaneous and Other Soft Tissues
...
9580-9582
...
Granular cell tumor and alveolar soft part sarcoma
...
C49._, Connective, Subcutaneous and Other Soft Tissues
...
9240-9252
...
Mesenchymal chondrosarcoma and giant cell tumors
...
C40._, C41._ for Bone and Cartilage
C49._, Connective, Subcutaneous and Other Soft Tissues
...
8940-8941
...
Mixed tumor, salivary gland type
...
C07._ for Parotid Gland
C08._ for Other and Unspecified Major Salivary Glands
The current Solid Tumor Rules, the Hematopoietic and Lymphoid Neoplasm Coding Manual and Database, and the International Classification of Diseases for Oncology, Third Edition, Second Revision Morphology (ICD-O-3.2) are the standard references for histology codes.
Histology Coding for Solid Tumors
Apply the general instructions and instructions for coding histologic type in the current Solid Tumor Rules.
Apply the site-specific histology coding rules in the current Solid Tumor Rules.
Refer to the most current Solid Tumor Rules for histology code changes.
1. Beginning with cases diagnosed 01/01/2022 forward, p16 test results can be used to code squamous cell carcinoma, HPV positive (8085) and squamous cell carcinoma, HPV negative (8086).
2. Beginning 1/1/2022, non-keratinizing squamous cell carcinoma, HPV positive is coded 8085 for sites listed in Head and Neck Solid Tumor Rules Table 5 only. A diagnosis of non-keratinizing squamous cell carcinoma, NOS is coded 8072.
3. Beginning 1/1/2022, keratinizing squamous cell carcinoma, HPV negative is coded 8086 for sites listed in Head and Neck Solid Tumor Rules Table 5 only. A diagnosis of keratinizing squamous cell carcinoma, NOS is coded 8071.
4. Clear cell papillary renal cell carcinoma is coded 8323/3. The 2016 WHO Classification of Tumors of the Urinary System and Male Genital Organs, 4th Edition, has reclassified this histology as a /1 because it is low nuclear grade and is now thought to be a neoplasia. This change has not yet been implemented and it remains reportable as behavior /3.
Site-specific histology coding rules cover the following sites/types.
Primary Site | Topography |
|---|---|
Head and Neck | C000-C148, C300-C329, C410, C411, C442 |
Colon, Rectosigmoid, Rectum | C180-C189, C199, C209 |
Lung | C340-C349 |
Cutaneous Melanoma | C440-C449 with Histology 8720-8780 |
Breast | C500-C506, C508-C509 |
Kidney | C649 |
Urinary Sites | C659, C669, C670-C679, C680-C681, C688-C689 |
Non-malignant CNS | C700, C701, C709, C710-C719, C720-C725, C728, C729, C751-C753 |
Malignant CNS and Peripheral Nerves | C470-C479, C700, C701, C709, C710-C719, C720-C725, C728, C729, C751-C753 |
Other Sites | Excludes Head and Neck, Colon, Rectosigmoid, Rectum, Lung, Cutaneous Melanoma, Breast, Kidney, Urinary Sites, Peripheral Nerves, CNS |
Histology Coding for Hematopoietic and Lymphatic Primaries
Apply the Histology Coding Rules in the Hematopoietic and Lymphoid Neoplasm Coding Manual and Database.Refer to the introductory pages of the International Classification of Diseases for Oncology, 3rd edition, for a more detailed discussion of the rules governing the appropriate assignment of ICD-O codes. See also APPENDIX J for errata and clarifications to ICD-O-3rd edition.
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