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Tumor Tip of the Week-pM1 Stage & Grade

Scenario: (Biopsy proven Rectum primary with biopsy proven mets to liver) Colonoscopy biopsy rectum+ moderately differentiated adenocarcinoma.  Needle biopsy of liver + metastatic adenocarcinoma, CT/EUS show clinical T3, clinical N1 case. No resection is done, patient has pathologically confirmed mets…

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Tumor Tip of the Week-Ovarian Grade

Scenario:  06-18-2020 Ovarian primary TAH/BSO- endometrioid adenocarcinoma-FIGO grade 1, however, focal areas (1-2%) with high nuclear grade, consistent with FIGO grade 2 Question:  How would the pathological grade be coded? 1 G1: Well differentiated 2 G2: Moderately differentiated 3 G3:…

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Tumor Tip of the Week-Planning Technique

Scenario: 05-05-2020 -05-08-2020 LUL 5400cGy in 3 fractions (1800 cGy/fx) 10 MV hyperfractionated IMRT based stereotactic body radiotherapy Question:  How would Phase I External Beam Radiation Planning Technique be coded? 05 Intensity modulated therapy (IMRT) 06 Stereotactic radiotherapy or radiosurgery,…

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Tumor Tip of the Week-Diagnostic Confirmation

Scenario:  4-10-2020 CT Abdomen/Pelvis: Bilobed hypoenhancing mass within the pancreatic body/tail compatible with a primary pancreatic malignancy. Metastatic disease could have a similar appearance. 04-09-2020 CA 19-9    28,600 U/mL   HIGH Managing Physician Statement: Metastatic cancer most likely pancreatic origin. I…

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