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?