lip, upper lip (vermilion or labial mucosa) c00.0, c00 · compact outer layer of bone. trabecular,...

Collaborative Stage Data Collection System Coding Instructions PART II: Site-Specific Schemas

The official version of this document is online at www.cancerstaging.org/cstage/manuals.

29 April 2010 Part II - Lip - 1 Version 02.02.00

Lip, Upper

Lip (Vermilion or Labial Mucosa)

C00.0, C00.3 C00.0 External upper lip

C00.3 Mucosa of upper lip

Note: AJCC includes labial mucosa (C00.3) with buccal mucosa (C06.0)

CS Tumor Size CS Extension CS Tumor Size/Ext Eval CS Lymph Nodes CS Lymph Nodes Eval Reg LN Pos Reg LN Exam CS Mets at DX CS Mets Eval

CS Site-Specific Factor 1 Size of Lymph Nodes CS Site-Specific Factor 2 OBSOLETE -

Extracapsular Extension, Lymph Nodes for

Head and Neck CS Site-Specific Factor 3 Levels I-III, Lymph

Nodes for Head and Neck CS Site-Specific Factor 4 Levels IV-V and

Retropharyngeal Lymph Nodes for Head and

Neck CS Site-Specific Factor 5 Levels VI-VII and

Facial Lymph Nodes for Head and Neck CS Site-Specific Factor 6 Parapharyngeal,

Parotid, and Suboccipital/Retroauricular Lymph

Nodes, Lymph Nodes for Head and Neck CS Site-Specific Factor 7 Upper and Lower

Cervical Node Levels CS Site-Specific Factor 8 Extracapsular

Extension Clinically, Lymph Nodes for Head

and Neck CS Site-Specific Factor 9 Extracapsular

Extension Pathologically, Lymph Nodes for

Head and Neck CS Site-Specific Factor 10 HPV (Human

Papilloma Virus) Status CS Site-Specific Factor 11 Measured Thickness

(Depth) CS Site-Specific Factor 12 CS Site-Specific Factor 13 CS Site-Specific Factor 14 CS Site-Specific Factor 15 CS Site-Specific Factor 16 CS Site-Specific Factor 17 CS Site-Specific Factor 18 CS Site-Specific Factor 19 CS Site-Specific Factor 20 CS Site-Specific Factor 21 CS Site-Specific Factor 22 CS Site-Specific Factor 23 CS Site-Specific Factor 24 CS Site-Specific Factor 25

The following tables are

available at the collaborative

staging website:

Histology Inclusion Table

AJCC 7th ed. Histology Exclusion Table

AJCC 6th ed. AJCC TNM 7 Stage AJCC TNM 6 Stage Summary Stage Extension Size Table Lymph Nodes Size Table




Lip, Upper

CS Tumor Size (Revised: 10/18/2009) Note 1: Code the specific tumor size as stated in the medical record. Use code 992, 994, or 995 if the physician's

statement about T value is the ONLY information available about the size of the tumor. (Refer to the CS Extension

table for instructions on coding extension.)

Code Description

000 No mass/tumor found

001-988 001 - 988 millimeters (code exact size in millimeters)

989 989 millimeters or larger

990 Microscopic focus or foci only, no size of focus given

991 Described as "less than 1 cm"

992 Described as "less than 2 cm," or "greater than 1 cm," or "between 1 cm and 2 cm"

Stated as T1 with no other information on size






996 Described as "greater than 5cm"

999 Unknown; size not stated

Not documented in patient record

Lip, Upper

CS Extension (Revised: 10/23/2009) Note 1: Periosteum is a fibrous membrane that wraps the outer surface of bones. Cortical bone is the dense

compact outer layer of bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling

the interior of bone, decreasing weight and allowing room for blood vessels and marrow.

Note 2: AJCC assigns T value based on size when bone involvement is limited to the cortex. Involvement through

cortical bone is required for assignment of T4a.

Note 2: Use code 300 for localized tumor ONLY if no information is available to assign codes 100, 200, 405, 410,

or 415.

Note 3: Use code 405, 410, 415, 778, 810, or 815 if the physician's assignment of T category is the ONLY

information available for the extent of the tumor.

Code Description TNM 7 TNM 6 SS77 SS2000

000 In situ; noninvasive; intraepithelial Tis Tis IS IS





100 Invasive tumor confined to:

Labial mucosa (inner lip)

Lamina propria

Multiple foci

Submucosa (superficial invasion)

Vermilion surface

Superficial extension to:

Skin of lip

Subcutaneous soft tissue of lip

^ * L L

200 Musculature ^ * L L

300 Localized, NOS ^ * L L

405 Stated as T1 with no other information on extension ^ * L L



500 Buccal mucosa (inner cheek)

Commissure

Opposite (both) lip(s)

^ * RE RE

510 Upper gingiva Gingiva, NOS (Note: Lower gingiva

moved to code 780)

^ * RE RE

535 Cortical bone of maxilla

Cortical bone NOS (not specified in higher codes)

Bone, NOS (not specified in higher codes)

^ * RE RE

700 OBSOLETE DATA RETAINED V0200

Maxilla

ERROR T4a RE RE

725 Trabecular bone of maxilla T4a T4a RE RE

740 Nose T4a T4a RE D

750 Tongue T4a T4a D D

760 Skin of face/neck T4a T4a D D


Cortical bone (other than code 700)

Floor of mouth

Inferior alveolar nerve

ERROR T4a D D

775 Floor of mouth


T4a T4a D D

778 Stated as T4a with no other information on extension T4a T4a RE RE

780 Lower gingiva T4b T4b D RE





785 780 + (740, 750, 760, or 775)

(Lower gingiva + any structure in 740, 750, 760, or

775)

T4b T4b D D

788 Bone of mandible

Mandible NOS

Specified bone (Other than maxilla, mandible, and

bones in codes 790 and 800)

T4b T4b D D

790 Masticator space

Pterygoid plates

T4b T4b D D

800 Further contiguous extension including:

Skull base

Internal carotid artery (encased)

T4b T4b D D

810 Stated as T4b with no other information on extension T4b T4b D D

815 Stated as T4 [NOS] with no other information on

extension

T4NOS T4NOS RE RE

950 No evidence of primary tumor T0 T0 U U

999 Unknown extension

Primary tumor cannot be assessed


TX TX U U

^ For Extension codes 100 through 535 ONLY, the T category for AJCC 7th Edition staging is assigned based on

the value of CS Tumor Size, as shown in the Extension Size Table for this site.

* For Extension codes 100 through 535 ONLY, the T category for AJCC 6th Edition staging is assigned based on


Lip, Upper

CS Tumor Size/Ext Eval (Revised: 08/10/2009)

Code Description Staging

Basis

0 Does not meet criteria for AJCC pathologic staging:

No surgical resection done. Evaluation based on physical examination, imaging

examination, or other non-invasive clinical evidence. No autopsy evidence used.

c


No surgical resection done. Evaluation based on endoscopic examination, diagnostic

biopsy, including fine needle aspiration biopsy, or other invasive techniques, including

surgical observation without biopsy. No autopsy evidence used.

c





Basis

2 Meets criteria for AJCC pathologic staging:

No surgical resection done, but evidence derived from autopsy (tumor was suspected or

diagnosed prior to autopsy)

p

3 Either criteria meets AJCC pathologic staging:

Surgical resection performed WITHOUT pre-surgical systemic treatment or radiation

OR surgical resection performed, unknown if pre-surgical systemic treatment or radiation

performed

AND Evaluation based on evidence acquired before treatment, supplemented or modified

by the additional evidence acquired during and from surgery, particularly from

pathologic examination of the resected specimen.

No surgical resection done. Evaluation based on positive biopsy of highest T classification.

p

5 Does not meet criteria for AJCC y-pathologic (yp) staging:

Surgical resection performed AFTER neoadjuvant therapy and tumor size/extension based

on clinical evidence, unless the pathologic evidence at surgery (AFTER neoadjuvant)

is more extensive (see code 6).

c

6 Meets criteria for AJCC y-pathologic (yp) staging:

Surgical resection performed AFTER neoadjuvant therapy AND tumor size/extension

based on pathologic evidence, because pathologic evidence at surgery is more

extensive than clinical evidence before treatment.

yp

8 Meets criteria for autopsy (a) staging:

Evidence from autopsy only (tumor was unsuspected or undiagnosed prior to autopsy)

a

9 Unknown if surgical resection done

Not assessed; cannot be assessed

Unknown if assessed


c




Lip, Upper

CS Lymph Nodes (Revised: 01/25/2010) Note 1: For head and neck schemas, this field includes all lymph nodes defined as Levels I-VII and Other by

AJCC. The complete definitions are provided in the General Instructions.

Note 2: For head and neck schemas, additional information about lymph nodes (size of involved nodes,

extracapsular extension, levels involved, and location of involved nodes above or below the lower border of the

cricoid cartilage) is coded in Site-Specific Factors 1, 3-9.

Note 3: If laterality of lymph nodes is not specified, assume nodes are ipsilateral. Midline nodes are considered

ipsilateral.

Note 4: For head and neck cancers, if lymph nodes are described only as "supraclavicular", try to determine if they

are in Level IV (deep to the sternocleidomastoid muscle, in the lower jugular chain) or Level V (in the posterior

triangle, inferior to the transverse cervical artery) and code appropriately. If the specific level cannot be determined,

consider them as Level V nodes.

Note 5: The description of lymph nodes has been standardized across the head and neck schemas. All lymph node

levels and groups listed here are considered regional nodes for AJCC staging. Summary Stage 1977 and Summary

Stage 2000 divide these nodes into regional and distant groups.

Note 6: Level I nodes moved from code 110 in CSv1 to code 105.


000 None; no regional lymph node involvement N0 N0 NONE NONE

100 Single positive ipsilateral regional node:

Other groups:

Facial:

Buccinator (buccal)

Nasolabial

Parotid

Infraauricular

Intraparotid

Periparotid

Preauricular

Regional lymph node, NOS

^ * RN RN


Level 1A

Submental

Level IB

Submandibular (submaxillary)

^ * RN D


Level II node - Upper jugular

Jugulodigastric (subdigastric)

Upper deep cervical

Level IIA

Level IIB

Level III node - Middle jugular

Middle deep cervical

Level IV node - Lower jugular

Jugulo-omohyoid (supraomohyoid)

Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS

Internal jugular, NOS

^ * D RN






Level V node

Posterior triangle group

Posterior cervical

Level VA - Spinal accessory

Level VB - Transverse cervical,

supraclavicular

Level VI node - Anterior compartment group

Laterotracheal

Paralaryngeal

Paratracheal - above suprasternal notch

Perithyroidal

Precricoid (Delphian)

Prelaryngeal

Pretracheal - above suprasternal notch

Recurrent laryngeal

Level VII node - Superior mediastinal group (for

other mediastinal nodes see CS Mets at DX)

Esophageal groove

Paratracheal - below suprasternal notch

Pretracheal - below suprasternal notch

Other groups:

Facial:

Mandibular

Parapharyngeal

Retroauricular

Retropharyngeal

Sublingual

Suboccipital

^ * D D

180 Stated as N1, no other information N1 N1 RN RN

190 Stated as N2a, no other information N2a N2a RN RN

200 Multiple positive ipsilateral nodes listed in code 100 ^ * RN RN

205 Multiple positive ipsilateral nodes, any listed in code

105 (WITH or WITHOUT nodes listed in code

100)

^ * RN D



100)

^ * D RN

215 Multiple positive ipsilateral nodes listed in both codes

105 and 110 (WITH or WITHOUT nodes listed in

code 100)

^ * D D



100, 105, or 110)

^ * D D

290 Stated as N2b, no other information N2b N2b RN RN





300 Regional lymph nodes listed in code 100:

Positive ipsilateral node(s), not stated if single or

multiple

^ * RN RN



multiple

^ * RN D



multiple

^ * D RN



multiple

^ * D D


Positive bilateral or contralateral nodes

^ * RN RN

405 Regional lymph nodes, any listed in code 105:

Positive bilateral or contralateral nodes (WITH or

WITHOUT nodes listed in code 100)

^ * RN D




^ * D RN

415 Regional lymph nodes listed in both codes 105 and 110:



^ * D D



WITHOUT nodes listed in code 100, 105, or 110)

^ * D D

490 Stated as N2c, no other information N2c N2c RN RN


Positive node(s), not stated if ipsilateral, or bilateral, or

contralateral,

AND not stated if single or multiple

^ * RN RN



contralateral,


^ * RN D



contralateral,


^ * D RN

520 Regional lymph nodes as listed in code 120:


contralateral,


^ * D D





600 Stated as N2, NOS N2NOS N2NOS RN RN


800 Lymph nodes, NOS, no other information ^ * RN RN

999 Unknown; not stated

Regional lymph nodes cannot be assessed


NX NX U U

^ For codes 100-120, 200-220, 300-320, 400-420, 500-520, and 800 ONLY, the N category for AJCC 7th Edition

staging is assigned based on the value of Site-Specific Factor 1, Size of Lymph Nodes, using the extra table, Lymph

Nodes Size Table, for this site.

* For codes 100-120, 200-220, 300-320, 400-420, 500-520, and 800 ONLY, the N category for AJCC 6th Edition



Lip, Upper

CS Lymph Nodes Eval (Revised: 10/26/2009) Note 1: This field is used primarily to derive the staging basis for the N category in the TNM system. It records

how the code for the item "CS Lymph Nodes" was determined based on the diagnostic methods employed and their

intent.

Note 2: In the 7th edition of the AJCC manual, the clinical and pathologic classification rules for the N category were

changed to reflect current medical practice. The N is designated as clinical or pathologic based on the intent

(workup versus treatment) matching with the assessment of the T classification. When the intent is workup, the

staging basis is clinical, and when the intent is treatment, the staging basis is pathologic.

A. Microscopic assessment including biopsy of regional nodes or sentinel nodes if being performed as part of

the workup to choose the treatment plan, is therefore part of the clinical staging. When it is part of the workup, the

T category is clinical, and there has not been a resection of the primary site adequate for pathologic T classification

(which would be part of the treatment).

B. Microscopic assessment of regional nodes if being performed as part of the treatment is therefore part of the

pathologic staging. When it is part of the treatment, the T category is pathologic, and there has been a resection of

the primary site adequate for pathologic T classification (all part of the treatment).

Note 3: Microscopic assessment of the highest N category is always pathologic (code 3).

Note 4: If lymph node dissection is not performed after neoadjuvant therapy, use code 0 or 1.

Note 5: Only codes 5 and 6 are used if the node assessment is performed after neoadjuvant therapy.


Basis


No regional lymph nodes removed for examination. Evidence based on physical

examination, imaging examination, or other non-invasive clinical evidence. No

autopsy evidence used.

c





Basis

1 Does not meet criteria for AJCC pathologic staging based on at least one of the following

criteria:

No regional lymph nodes removed for examination. Evidence based on endoscopic

examination, or other invasive techniques including surgical observation, without

biopsy. No autopsy evidence used.

OR

Fine needle aspiration, incisional core needle biopsy, or excisional biopsy of regional

lymph nodes or sentinel nodes as part of the diagnostic workup, WITHOUT removal

of the primary site adequate for pathologic T classification (treatment).

c


No regional lymph nodes removed for examination, but evidence derived from autopsy

(tumor was suspected or diagnosed prior to autopsy).

p

3 Meets criteria for AJCC pathologic staging based on at least one of the following criteria:

Any microscopic assessment of regional nodes (including FNA, incisional core needle bx,

excisional bx, sentinel node bx or node resection), WITH removal of the primary site

adequate for pathologic T classification (treatment) or biopsy assessment of the highest

T category.

OR

Any microscopic assessment of a regional node in the highest N category, regardless of the

T category information.

p


Regional lymph nodes removed for examination AFTER neoadjuvant therapy AND lymph

node evaluation based on clinical evidence, unless the pathologic evidence at surgery

(AFTER neoadjuvant) is more extensive (see code 6).

c



node evaluation based on pathologic evidence, because the pathologic evidence at

surgery is more extensive than clinical evidence before treatment.

yp

8 Meets criteria for AJCC autopsy (a) staging:

Evidence from autopsy; tumor was unsuspected or undiagnosed prior to autopsy.

a

9 Unknown if lymph nodes removed for examination


Unknown if assessed


c




Lip, Upper

Reg LN Pos (Revised: 03/30/2009) Note: Record this field even if there has been preoperative treatment.

Code Description

00 All nodes examined negative.

01-89 1 - 89 nodes positive (code exact number of nodes positive)

90 90 or more nodes positive

95 Positive aspiration or core biopsy of lymph node(s)

97 Positive nodes - number unspecified

98 No nodes examined

99 Unknown if nodes are positive; not applicable


Lip, Upper

Reg LN Exam (Revised: 03/02/2009)

Code Description


01-89 1 - 89 nodes examined (code exact number of regional lymph nodes examined)

90 90 or more nodes examined

95 No regional nodes removed, but aspiration or core biopsy of regional nodes performed

96 Regional lymph node removal documented as sampling and number of nodes unknown/not stated

97 Regional lymph node removal documented as dissection and number of nodes unknown/not stated

98 Regional lymph nodes surgically removed but number of lymph nodes unknown/not stated and not

documented as sampling or dissection; nodes examined, but number unknown

99 Unknown if nodes were examined; not applicable or negative


Lip, Upper

CS Mets at DX (Revised: 07/23/2009) Note: Supraclavicular and transverse cervical lymph nodes are coded in CS Lymph Nodes because they are

categorized as N rather than M in AJCC TNM.


00 No; none M0 M0 NONE NONE

10 Distant lymph node(s)

Mediastinal

Distant lymph node(s), NOS

M1 M1 D D





40 Distant metastases except distant lymph node(s)(code

10)

Carcinomatosis

M1 M1 D D

50 (10) + (40)

Distant lymph node(s) plus other distant metastases

M1 M1 D D

60 Distant metastasis, NOS

Stated as M1, NOS

M1 M1 D D

99 Unknown if distant metastasis

Distant metastasis cannot be assessed


M0 MX U U

Lip, Upper

CS Mets Eval (Revised: 08/10/2009) Note: This item reflects the validity of the classification of the item CS Mets at DX only according to the

diagnostic methods employed.


Basis

0 Does not meet criteria for AJCC pathologic staging of distant metastasis:

Evaluation of distant metastasis based on physical examination, imaging examination,

and/or other non-invasive clinical evidence. No pathologic examination of metastatic

tissue performed or pathologic examination was negative.

c


Evaluation of distant metastasis based on endoscopic examination or other invasive

technique, including surgical observation without biopsy. No pathologic examination

of metastatic tissue performed or pathologic examination was negative.

c

2 Meets criteria for AJCC pathologic staging of distant metastasis:

No pathologic examination of metastatic specimen done prior to death, but positive

metastatic evidence derived from autopsy (tumor was suspected or diagnosed prior to

autopsy).

p


Specimen from metastatic site microscopically positive WITHOUT pre-surgical systemic

treatment or radiation

OR specimen from metastatic site microscopically positive, unknown if pre-surgical

systemic treatment or radiation performed

OR specimen from metastatic site microscopically positive prior to neoadjuvant treatment.

p

5 Does not meet criteria for AJCC y-pathologic (yp) staging of distant metastasis:

Specimen from metastatic site microscopically positive WITH pre-surgical systemic

treatment or radiation, BUT metastasis based on clinical evidence.

c





Basis

6 Meets criteria for AJCC y-pathologic (yp) staging of distant metastasis:


treatment or radiation, BUT metastasis based on pathologic evidence.

yp

8 Meets criteria for AJCC autopsy (a) staging of distant metastasis:

Evidence from autopsy based on examination of positive metastatic tissue AND tumor was

unsuspected or undiagnosed prior to autopsy.

a

9 Not assessed; cannot be assessed

Unknown if assessed


c

Lip, Upper

CS Site-Specific Factor 1 Size of Lymph Nodes (Revised: 12/01/2009) Note: Code the largest diameter, whether measured clinically or pathologically, of any involved regional lymph

node(s). Do not code the size of any nodes coded in CS Mets at DX.

Code Description

000 No involved regional nodes

001-979 001-979 millimeters (code exact size in millimeters)


981-988 OBSOLETE DATA CONVERTED V0200

See code 980

981-988 millimeters

989 OBSOLETE DATA CONVERTED V0200

See code 980

989 millimeters or larger


991 Described as "less than 1cm"

992 Described as "less than 2cm" or "greater than 1cm" or "between 1cm and 2cm"





997 Described as "more than 6cm"




Code Description

999 Regional lymph node(s) involved, size not stated

Unknown if regional lymph node(s) involved


Lip, Upper

CS Site-Specific Factor 2 OBSOLETE - Extracapsular Extension, Lymph Nodes for Head

and Neck (Revised: 12/30/2009) Note 1: This CS Site-Specific Factor is obsolete beginning with CS Version 2 (codes and notes). Old data are

retained, but new cases are not coded with this Factor. Use code 988 for this field.

Note 2: Code the status of extracapsular extension whether assessed clinically or pathologically of any involved

regional lymph node(s) coded in the CS Lymph Nodes field. Do not code extracapsular extension in any nodes

coded in CS Mets at DX in this field.

Note 3: A statement of the presence or absence of extracasular extension in a pathology report takes priority over

clinical assessment. However, if the pathology report contains no statement about extracapsular extension, either

positive or negative, the clinical assessment should be coded. If nodes are involved but there is neither a clinical

assessment of extranodal extension nor a statement about it in the pathology report, use code 999.

Note 4: According to AJCC (page 24), "Imaging studies showing amorphous speculated margins of involved nodes

or involvement of internodal fat resulting in loss of normal oval-to-round nodal shape strongly suggest extracapsular

(extranodal) tumor spread; however, pathologic examination is necessary for documentation of the extent of such

disease."

Note 5: CS Site-Specific Factor 2 is obsolete beginning with CS Version 2 (codes and notes). Old data are retained,

but new cases are not coded with this Factor. Use code 988 for this field.

Code Description


No extracapsular extension


Extracapsular extension clinically, not assessed pathologically

Nodes described as "fixed", not assessed pathologically


Extracapsular extension present pathologically


See code 987

Not applicable; no lymph node involvement

987 OBSOLETE DATA CONVERTED AND RETAINED V0200

Data converted from code 888


988 Not applicable:

Information not collected for this case


Unknown if regional lymph node(s) involved, not stated






Lip, Upper

CS Site-Specific Factor 3 Levels I-III, Lymph Nodes for Head and Neck (Revised: 03/30/2009) Note: Site-Specific Factors 3-6 are used to code the presence or absence of lymph node involvement in each of 7

different levels and other groups defined by AJCC. The definitions of the levels are the same for all applicable head

and neck sites. One digit is used to represent lymph nodes of a single level, with the three digits of Site-Specific

Factor 3 representing lymph nodes of, respectively, Levels I-III; the digits of Site-Specific Factor 4 representing

lymph nodes of Levels IV and V and the retropharyngeal nodes; the digits of Site-Specific Factor 5 representing

lymph nodes of Levels VI and VII and the facial nodes; and the digits of Site-Specific Factor 6 representing the

remaining Other groups as defined by AJCC. In each digit, a code 1 means Yes, the nodes are involved.

Code Description

000 No lymph node involvement in Levels I, II, or III

100 Level I lymph node(s) involved

010 Level II lymph node(s) involved

001 Level III lymph node(s) involved

110 Level I and II lymph nodes involved

101 Level I and III lymph nodes involved

011 Level II and III lymph nodes involved

111 Level I, II and III lymph nodes involved

999 Unknown if regional lymph node(s) involved, not stated



Lip, Upper

CS Site-Specific Factor 4 Levels IV-V and Retropharyngeal Lymph Nodes for Head and

Neck (Revised: 03/30/2009) Note: Site-Specific Factors 3-6 are used to code the presence or absence of lymph node involvement in each of 7







Code Description

000 No lymph node involvement in Levels IV or V or retropharyngeal

100 Level IV lymph node(s) involved

010 Level V lymph node(s) involved

001 Retropharyngeal nodes involved

110 Level IV and V lymph nodes involved

101 Level IV and retropharyngeal nodes involved




Code Description

011 Level V and retropharyngeal nodes involved

111 Level IV and V and retropharyngeal lymph nodes involved




Lip, Upper

CS Site-Specific Factor 5 Levels VI-VII and Facial Lymph Nodes for Head and Neck (Revised:

03/30/2009) Note 1: Site-Specific Factors 3-6 are used to code the presence or absence of lymph node involvement in each of 7







Note 2: Facial nodes including buccinator, mandibular, and nasolabial lymph nodes.

Code Description

000 No lymph node involvement in Levels VI or VII or facial nodes

100 Level VI lymph node(s) involved

010 Level VII lymph node(s) involved

001 Facial lymph node(s) involved

110 Level VI and VII lymph nodes involved

101 Level VI and facial nodes involved

011 Level VII and facial nodes involved

111 Level VI and VII and facial lymph nodes involved







Lip, Upper

CS Site-Specific Factor 6 Parapharyngeal, Parotid, and Suboccipital/Retroauricular

Lymph Nodes, Lymph Nodes for Head and Neck (Revised: 08/25/2009) Note: Site-Specific Factors 3-6 are used to code the presence or absence of lymph node involvement in each of 7







Code Description

000 No involvement of any group:

Parapharyngeal lymph nodes

Parotid (preauricular, periparotid, and/or intraparotid) lymph nodes

Suboccipital/retroauricular lymph nodes

100 Parapharyngeal lymph node(s) involved

010 Parotid (preauricular, periparotid, and/or intraparotid) lymph node(s) involved

001 Suboccipital/retroauricular lymph node(s) involved

110 Involvement of two groups:








Suboccipital lymph nodes

111 Involvement of three groups:



, Suboccipital/retroauricular lymph nodes







Lip, Upper

CS Site-Specific Factor 7 Upper and Lower Cervical Node Levels (Revised: 03/30/2009) Note 1: AJCC requires that nodes be designated as involving upper or lower levels within the neck. The boundary

between upper and lower levels is the lower border of the cricoid cartilage.

Note 2: Nodes in Levels I, II, and III are upper level nodes. Nodes in Level IV and VII are lower level nodes.

Level VA nodes are upper level nodes, and Level VB are lower level nodes. Level VI nodes span both upper and

lower levels. Nodes included in "Other groups" (Facial, Parotid, Parapharyngeal, Retropharyngeal, Retroauricular,

and Suboccipital) are all upper level nodes.

Note 3: Code the location of nodal involvement in relation to the lower border of the cricoid cartilage of all

involved nodes, whether assessed clinically or pathologically, as stated by a physician.

Note 4: If there is no physician statement of upper and/or lower level nodal involvement, assign levels I, II, III, and

VA nodes to upper level. Assign level IV, VB, and VII to lower level. If Level V (A and B not specified) and/or

Level VI nodes are involved with no further information about location, use code 040.

Note 5: A description of "mid neck" requires clarification with the physician. Code 040, unknown level, if "mid

neck" is the only information available.

Code Description

000 No lymph nodes involved

010 Upper level lymph nodes involved (all involved nodes above the lower border of the cricoid cartilage)

020 Lower level lymph nodes involved (all involved nodes below the lower border of the cricoid cartilage)

030 Upper and lower level lymph nodes involved (all involved nodes both above and below the lower

border of the cricoid cartilage)

040 Unknown level lymph nodes involved (unable to determine if involved nodes above or below the lower


988 Not applicable:


999 Unknown if regional lymph node(s) involved, not stated Not documented in patient record

Lip, Upper

CS Site-Specific Factor 8 Extracapsular Extension Clinically, Lymph Nodes for Head and

Neck (Revised: 10/16/2009) Note 1: Code the status of extracapsular extension accessed clinically for any involved regional lymph node(s)

coded in the CS Lymph Nodes field. Do not code extracapsular extensio in any nodes coded in CS Mets at DX in

this field.

Note 2: If nodes are involved clinically, and documentation of physical examination or imaging is available

without a statement of extracapsular extension, use code 010.

Note 3: If the only documentation is a reference to clinically involved nodes with no reference to extracapsular

extension, use code 030.

Note 4: If there is no information about clinical assessment of nodes, use code 999.

Note 5: Clinical assessment can be by physical examination or imaging. According to AJCC, "ECS can be

diagnosed clinically by a matted mass of nodes adherent to overlying skin, adjacent soft tissue, or clinical evidence

of cranial nerve tissue. Radiologic signs of ECS include amorphous, spiculated margins of a metastatic node and

stranding of the perinodal soft tissue in previously untreated patients."

Code Description

000 No lymph nodes involved clinically

010 Nodes involved clinically, no extracapsular extension clinically




Code Description

020 Nodes involved clinically, extracapsular extension clinically (nodes described as fixed or matted)

030 Nodes involved clinically, unknown if extracapsular extension

988 Not applicable:


997 Clinical examination of lymph nodes performed, unknown results

998 No clinical examination of lymph nodes

999 Unknown if regional lymph node(s) involved clinically, not stated Regional lymph nodes cannot be

accessed Not documented in patient record

Lip, Upper

CS Site-Specific Factor 9 Extracapsular Extension Pathologically, Lymph Nodes for Head

and Neck (Revised: 08/25/2009) Note 1: Code the status of extracapsular extension assessed pathologically of any involved regional lymph node(s)

coded in the CS Lymph Nodes field. Do not code extracapsular extension in any nodes coded in CS Mets at DX in

this field.

Note 2: If nodes are involved pathologically but there is no statement of extranodal extension in the pathology

report, use code 010.

Note 3: Code "microscopic" or "macroscropic" extranodal extension as stated in the final diagnosis. If not stated in

the final diagnosis, code "microscopic" if extranodal extension is described only in the microscopic section of the

pathology report and "macroscopic" if extranodal extension is described in the gross section of the pathology report.

Note 4: "Macroscopic" extension takes priority over "microscopic" extension.

Note 5: Use code 040 if pathologic extracapsular extension is described with no further information and the

pathology report is not available for review.

Note 6: Use code 050 if nodes involved pathologically with no further information about extracapsular extension.

Code Description

000 No lymph nodes involved pathologically

010 Nodes involved pathologically, no extracapsular extension pathologically

020 Nodes involved pathologically, MICROSCOPIC extracapsular extension pathologically

030 Nodes involved pathologically, MACROSCOPIC extracapsular extension pathologically

040 Nodes involved pathologically, extracapsular extension pathologically, unknown if microscopic or

macroscopic

050 Nodes involved pathologically, unknown if extracapsular extension

988 Not applicable:


997 Pathologic examination of lymph nodes performed, results not available

998 No pathologic examination of lymph nodes

999 Unknown if regional lymph node(s) involved pathologically, not stated




Lip, Upper

CS Site-Specific Factor 10 HPV (Human Papilloma Virus) Status (Revised: 10/12/2009) Note 1: There is evidence that human papilloma virus (HPV) plays a role in the pathogenesis of some cancers.

Note 2: Record the results of any HPV testing performed on pathologic specimens from the primary tumor or a

metastatic site, including regional nodes. HPV testing may be performed for prognostic purposes; testing may also

be performed on metastatic sites to aid in the determination of the primary site.

Note 3: The highest risk HPV types are types 16 and 18. Other high risk types are 31, 33, 35, 36, 45, 51, 52, 56, 58,

59, 68, 26, 53, 66, 67, 69, 70, 73, 82, 85 Low risk types are 6, 11, 32, 34, 40, 42, 44, 54, 61, 62, 64, 71, 72, 74, 81,

83, 84, 87, 89. The HPV vaccine is designed to protect against types 16 and 18 (associated with cervical cancer) and

types 6 and 11 (associated with genital warts).

Note 4: High risk may be abbreviated "hrHPV" or "HR-HPV".

Note 5: Some tests for HPV, such as a hybrid capture test, only report negative or positive for high risk HPV

without identifying types; use codes 025 and 050, respectively to report those test results.

Code Description

000 HPV test negative; not positive for any HPV types

Negative, NOS

010 LOW RISK positive (all positive type(s) are low risk)

020 HIGH RISK positive, specified type(s) other than types 16 or 18,

WITH or WITHOUT positive results for low risk type(s)

030 HIGH RISK positive for HPV 16 WITHOUT positive results for HPV 18 or positivity of HPV 18

unknown,

WITH or WITHOUT positive results for other high-risk types,



unknown,



050 HIGH RISK positive for HPV 16 AND HPV 18,



060 HIGH RISK positive, NOS, type(s) not specified

070 Positive, NOS, risk and type(s) not stated

988 Not applicable:


997 Test ordered, results not in chart

998 Test not done (test was not ordered and was not performed), including no pathologic specimen

available for HPV testing

999 Unknown or no information





Lip, Upper

CS Site-Specific Factor 11 Measured Thickness (Depth) (Revised: 11/15/2009) Note 1: Code MEASURED THICKNESS (Depth) of the invasive tumor not size, diameter, or any other

measurement. Record the actual measurement in tenths of millimeters as stated on the pathology repot. Do not

record the measurement from a radiographic report.

Note 2: Record the measurement labeled specifically as thickness or depth of tumor. In the absence of a label,use

the "cut surface" dimension, or the third dimension from a description of 3 dimensions (N1 x N2 x N3). For

example, from a tumor size recorded as 2cm x 1cm x 0.5cm, record 050.

Code Description


001-979 Exact thickness in tenths of millimeters

Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters

100 10 millimeters, 1 centimeter

103 10.3 millimeters

980 98.0 millimeters or larger

987 Not applicable, in situ carcinoma

988 Not applicable:


990 Microinvasion

Microscopic focus or foci only; no depth given

998 No surgical specimen

999 Not documented in patient record

Unknown, thickness not stated

Lip, Upper

CS Site-Specific Factor 12 (Revised: 06/30/2008)

Code Description

988 Not applicable for this schema

Lip, Upper


Code Description





Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description





Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description


Lip, Upper


Code Description





Malignant Melanoma of Upper Lip


C00.0, C00.3 (M-8720-8790)

C00.0 External upper lip






















staging website:



AJCC 6th ed. AJCC TNM 7 Stage AJCC TNM 6 Stage Summary Stage





CS Tumor Size (Revised: 02/03/2010)

Code Description




990 Microscopic focus or foci only and no size of focus given









CS Extension (Revised: 01/04/2010) Note 1: AJCC does not include a Tis or TX category for melanoma of mucosa of head and neck sites. Extension codes of

000 and 999 will be mapped to NA and AJCC stage group will be derived as NA.

Note 2: AJCC does not include a T1 or T2 category for mucosal melanoma of head and neck sites.

Note 3: Use code 300 for localized tumor ONLY if no information is available to assign code 105 or 470.

Note 4: Use code 470, 775, 810, or 815 if the physician's assignment of T category is the ONLY information

available about the extent of the tumor.


000 In situ; noninvasive; intraepithelial NA NA IS IS


Invasive tumor confined to:


Lamina propria

Multiple foci


Vermilion surface


Skin of lip


ERROR NA L L

105 Tumor confined to mucosa of upper lip:


Vermilion surface

T3 NA L L






See code 520

Musculature

ERROR ERROR ERROR ERROR

300 Localized, NOS T3 NA L L

400 Extension via mucosa to:

Inner cheek (buccal mucosa)

Commissure


T3 NA RE RE


Upper gingiva

Gingiva NOS

T3 NA RE RE

440 Extension via mucosa to lower gingiva T3 NA D RE


Floor of mouth

Tongue

T3 NA D D

470 Stated as T3 with no other information on extension T3 NA L L


Buccal mucosa (inner cheek)

Commissure


ERROR NA RE RE


Gingiva

ERROR NA RE RE

520 Involvement of deep soft tissue or musculature of upper

lip

Soft tissue NOS

T4a NA L L

530 520 + (400 or 410)

(Involvement of deep soft tissue or musculature of

upper lip + Mucosal involvement of any structure

in code 400 or 410)

T4a NA RE RE

540 Involvement of deep soft tissue or musculature of any

structure in code 400

T4a NA RE RE

550 Involvement of deep tissue or periosteum of upper

gingiva

T4a NA RE RE

700 Cartilage of maxilla

Cartilage NOS

Cortical bone of maxilla

Cortical bone NOS

Maxilla, NOS

Bone NOS except skull base

T4a NA RE RE





705 (520, 540, or 700) + 440

(Any structure in code 520 or 540 + Mucosa of lower

gingiva)

T4a NA D RE

710 Deep tissue or periosteum of lower gingiva T4a NA D RE

740 Skin of nose T4a NA RE D

743 740 + (440 or 710)

(Skin of nose + Mucosa or deep tissue lower gingiva)

T4a NA D D

745 (520, 540, 700, 710, or 740) + 450

(Any structure in code 520, 540, 700, 710, or 740 +

Mucosa of floor of mouth or tongue)

T4a NA D D

748 Involvement of deep tissue or musculature of floor of

mouth or tongue


T4a NA D D


Tongue

ERROR NA D D

755 Extrinsic muscle of tongue

Genioglossus

Hyoglossus

Palatoglossus

Styloglossus

T4a NA D D

760 Skin of face/neck T4a NA D D

765 Cartilage of mandible

Cortical bone of mandible

Mandible NOS

T4a NA D D


Cartilage of mandible


Floor of mouth


ERROR NA D D

775 Stated as T4a with no other information on extension T4a NA L L

790 Contiguous extension:

Masticator space

Pterygoid plates

Skull base


T4b NA D D


Further contiguous extension

ERROR NA D D





801 Further contiguous extension:

Brain

Dura

Lower cranial nerves (IX, X, XI, XII)

Prevertebral space

Mediastinal structures

T4b NA D D

810 Stated as T4b with no other information on extension T4b NA D D

815 Stated as T4NOS with no other information on

extension

T4NOS NA L L


No evidence of primary tumor

ERROR NA U U




NA NA U U




Basis 7

Staging

Basis 6


No surgical resection done. Evaluation based on physical examination,

imaging examination, or other non-invasive clinical evidence. No autopsy

evidence used.

c


No surgical resection done. Evaluation based on endoscopic examination,

diagnostic biopsy, including fine needle aspiration biopsy, or other

invasive techniques, including surgical observation without biopsy. No


c


No surgical resection done, but evidence derived from autopsy (tumor was

suspected or diagnosed prior to autopsy)

p





Basis 7

Staging

Basis 6


Surgical resection performed WITHOUT pre-surgical systemic treatment or

radiation

OR surgical resection performed, unknown if pre-surgical systemic treatment or

radiation performed

AND Evaluation based on evidence acquired before treatment, supplemented or

modified by the additional evidence acquired during and from surgery,

particularly from pathologic examination of the resected specimen.

No surgical resection done. Evaluation based on positive biopsy of highest T

classification.

p


Surgical resection performed AFTER neoadjuvant therapy and tumor

size/extension based on clinical evidence, unless the pathologic evidence at

surgery (AFTER neoadjuvant) is more extensive (see code 6).

c


Surgical resection performed AFTER neoadjuvant therapy AND tumor

size/extension based on pathologic evidence, because pathologic evidence

at surgery is more extensive than clinical evidence before treatment.

yp


Evidence from autopsy only (tumor was unsuspected or undiagnosed prior to

autopsy)

a



Unknown if assessed


c












000 None; no regional lymph node involvement N0 NA NONE NONE





100 Positive regional node(s):

Buccinator (buccal)

Nasolabial

Parotid

Infraauricular

Intraparotid

Periparotid

Preauricular


N1 NA RN RN


Level 1A - Submental

Level 1B - Submandibular (submaxillary),

sublingual

N1 NA RN D




Upper deep cervical

Level IIA

Level IIB





Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS


N1 NA D RN






Level V node - Posterior triangle group

Posterior cervical



supraclavicular (see Note 3)


Laterotracheal

Paralaryngeal


Perithyroidal


Prelaryngeal


Recurrent laryngeal

Level VII node - Superior mediastinal group

(for other mediastinal nodes see CS Mets at

DX)

Esophageal groove



Mandibular

Other groups

Parapharyngeal

Retroauricular (mastoid)

Retropharyngeal

Suboccipital

N1 NA D D

180 Stated as N1, no other information N1 NA RN RN


Stated as N2a, no other information

ERROR NA RN RN


Multiple positive ipsilateral nodes listed in code 100

ERROR NA RN RN



ERROR NA D RN


Multiple positive ipsilateral nodes, any listed in code

120

ERROR NA D D


Stated as N2b, no other information

ERROR NA RN RN






Regional lymph nodes as listed in code 100:


multiple

ERROR NA RN RN


Regional lymph nodes as listed in code 110


multiple

ERROR NA D RN




multiple

ERROR NA D D




ERROR NA RN RN




ERROR NA D RN




ERROR NA D D


Stated as N2c, no other information

ERROR NA RN RN




contralateral,


ERROR NA RN RN




contralateral


ERROR NA D RN








contralateral,


ERROR NA D D


Stated as N2, NOS

ERROR NA RN RN


Stated as N3, no other information

ERROR NA RN RN

800 Lymph nodes, NOS, no other information N1 NA RN RN




NX NA U U




intent.
















Basis 7

Staging

Basis 6


No regional lymph nodes removed for examination. Evidence based on

physical examination, imaging examination, or other non-invasive clinical

evidence. No autopsy evidence used.

c





Basis 7

Staging

Basis 6

1 Does not meet criteria for AJCC pathologic staging based on at least one of the

following criteria:


endoscopic examination, or other invasive techniques including surgical

observation, without biopsy. No autopsy evidence used.

OR

Fine needle aspiration, incisional core needle biopsy, or excisional biopsy of

regional lymph nodes or sentinel nodes as part of the diagnostic workup,

WITHOUT removal of the primary site adequate for pathologic T

classification (treatment).

c


No regional lymph nodes removed for examination, but evidence derived from

autopsy (tumor was suspected or diagnosed prior to autopsy).

p

3 Meets criteria for AJCC pathologic staging based on at least one of the

following criteria:

Any microscopic assessment of regional nodes (including FNA, incisional core

needle bx, excisional bx, sentinel node bx or node resection), WITH

removal of the primary site adequate for pathologic T classification

(treatment) or biopsy assessment of the highest T category.

OR

Any microscopic assessment of a regional node in the highest N category,

regardless of the T category information.

p


Regional lymph nodes removed for examination AFTER neoadjuvant therapy

AND lymph node evaluation based on clinical evidence, unless the

pathologic evidence at surgery (AFTER neoadjuvant) is more extensive

(see code 6).

c



AND lymph node evaluation based on pathologic evidence, because the

pathologic evidence at surgery is more extensive than clinical evidence

before treatment.

yp


Evidence from autopsy; tumor was unsuspected or undiagnosed prior to

autopsy.

a



Unknown if assessed


c






Code Description











Code Description















00 No; none M0 NA NONE NONE


Mediastinal


M1 NA D D






10)

Carcinomatosis

M1 NA D D

50 10 + 40)

(Distant lymph node(s) + Other distant metastases)

M1 NA D D


Stated as M1, NOS

M1 NA D D




M0 NA U U





Basis 7

Staging

Basis 6


Evaluation of distant metastasis based on physical examination, imaging

examination, and/or other non-invasive clinical evidence. No pathologic

examination of metastatic tissue performed or pathologic examination was

negative.

c


Evaluation of distant metastasis based on endoscopic examination or other

invasive technique, including surgical observation without biopsy. No

pathologic examination of metastatic tissue performed or pathologic

examination was negative.

c


No pathologic examination of metastatic specimen done prior to death, but

positive metastatic evidence derived from autopsy (tumor was suspected or

diagnosed prior to autopsy).

p


Specimen from metastatic site microscopically positive WITHOUT pre-surgical

systemic treatment or radiation

OR specimen from metastatic site microscopically positive, unknown if pre-

surgical systemic treatment or radiation performed

OR specimen from metastatic site microscopically positive prior to neoadjuvant

treatment.

p





Basis 7

Staging

Basis 6


Specimen from metastatic site microscopically positive WITH pre-surgical

systemic treatment or radiation, BUT metastasis based on clinical

evidence.

c



systemic treatment or radiation, BUT metastasis based on pathologic

evidence.

yp


Evidence from autopsy based on examination of positive metastatic tissue AND

tumor was unsuspected or undiagnosed prior to autopsy.

a


Unknown if assessed


c




Code Description





See code 980

981-988 millimeters


See code 980











Code Description




















disease."



Code Description









See code 987





988 Not applicable:





Code Description













Code Description





















Code Description






Code Description




















Code Description
























Code Description









































Code Description








988 Not applicable:







this field.










Code Description






Code Description



988 Not applicable:










this field.










Code Description






macroscopic


988 Not applicable:




















Code Description


Negative, NOS





unknown,




unknown,








988 Not applicable:

















Code Description



Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters





988 Not applicable:


990 Microinvasion







Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description




Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description





Lip, Lower


C00.1, C00.4, C00.6 C00.1 External lower lip

C00.4 Mucosa of lower lip

C00.6 Commissure of lip





















staging website:







Lip, Lower




Code Description
















Lip, Lower


compact outer layer of bone.Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling





or 415.

Note 4: Use code 405, 410, 415, 778, 810, or 815 if the physician's assignment of T category is the ONLY

information available about the extent of the tumor.









Lamina propria

Multiple foci


Vermilion surface


Skin of lip


^ * L L







Commissure (from lower lip only)


^ * RE RE

510 Lower gingiva

Gingiva, NOS

Upper gingiva (from commissure only)

(Note: Upper gingiva from lower lip moved to code

780)

^ * RE RE

535 Cortical bone of mandible

Mandible, NOS

Cortical bone of maxilla (from commissure only)

Maxilla, NOS (from commissure only)

Cortical bone, NOS (not specified in higher codes)


^ * RE RE


Mandible

ERROR T4a RE RE

725 Trabecular bone of mandible

Trabecular bone of maxilla (from commissure only

T4a T4a RE RE






Floor of mouth


ERROR T4a D D





775 Floor of mouth


T4a T4a D D


780 Upper gingiva (from lower lip) T4b T4b D RE

785 780 + (740, 750, 760, or 775)

(Upper gingiva + Any structure in 740, 750, 760, or

775)

T4b T4b D D

788 Bone of maxilla (from lower lip)

Maxilla, NOS (from lower lip)

Specified bone (other than mandible, maxilla, and bones

in codes 790 and 800)

T4b T4b D D


Pterygoid plates

T4b T4b D D


Skull base


T4b T4b D D


815 Stated as T4 [NOS] with no other information on

extension

T4NOS T4NOS RE RE





TX TX U U





Lip, Lower



Basis




c





Basis





c




p




performed





p





c





yp



a



Unknown if assessed


c




Lip, Lower





cricoid cartilage)is coded in Site-Specific Factors 1, 3-9.


ipsilateral.











Level I node:

Level IA - Submental Level IB

Submandibular (submaxillary), sublingual

Other groups Mandibular

Parotid

Infraauricular

Intraparotid

Periparotid

Preauricular


^ * RN RN


Level II node - Upper jugular Jugulodigastric

(subdigastric)

Upper deep cervical

Level III node - Middle jugular Middle deep

cervical

Level IV node - Lower jugular Jugulo-

omohyoid (supraomohyoid)

Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS


^ * D RN







Posterior cervical



supraclavicular (see note 4) Level VI

node - Anterior compartment group

Laterotracheal

Paralaryngeal


Perithyroidal


Prelaryngeal


Recurrent laryngeal



Esophageal groove



Other groups

Facial

Buccinator (buccal)

Nasolabial

Parapharyngeal

Retroauricular

Retropharyngeal Suboccipital

^ * D D





110 (WITH or WITHOUT any nodes listed in code

100)

^ * D RN



100, 110)

^ * D D




multiple

^ * RN RN



multiple

^ * D RN







multiple

^ * D D



^ * RN RN



WITHOUT any nodes listed in code 100)

^ * D RN


Positive bilateral or contralateral node (WITH or

WITHOUT any nodes listed in code 100, 110)

^ * D D




contralateral,


^ * RN RN



contralateral,


^ * D RN



contralateral,


^ * D D







NX NX U U


staging is assigned based on the value of Site Specific Factor 1, Size of Lymph Nodes, using the extra table, Lymph



staging is assigned based on the value of Site Specific Factor 1, Size of Lymph Nodes, using the extra table, Lymph





Lip, Lower



intent.
















Basis





c


criteria:




OR




c




p





T category.

OR



p





Basis





c





yp



a



Unknown if assessed


c

Lip, Lower


Code Description









Lip, Lower


Code Description







Code Description








Lip, Lower






Mediastinal


M1 M1 D D


10)

Carcinomatosis

M1 M1 D D

50 (10) + (40)


M1 M1 D D


Stated as M1, NOS

M1 M1 D D




M0 MX U U

Lip, Lower




Basis





c





Basis





c




autopsy).

p







p




c




yp




a


Unknown if assessed


c

Lip, Lower



Code Description







Code Description


See code 980

981-988 millimeters


See code 980













Lip, Lower














disease."



Code Description






Code Description







See code 987





988 Not applicable:






Lip, Lower








Code Description












Code Description




Lip, Lower









Code Description












Lip, Lower










Code Description





Code Description











Lip, Lower









Code Description




















Code Description








Lip, Lower














Code Description








988 Not applicable:






Lip, Lower




this field.










Code Description





988 Not applicable:






Lip, Lower




this field.










Code Description





Code Description





macroscopic


988 Not applicable:





Lip, Lower












Code Description


Negative, NOS





unknown,




unknown,






Code Description






988 Not applicable:







Lip, Lower







Code Description



Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters





988 Not applicable:


990 Microinvasion








Lip, Lower


Code Description


Lip, Lower


Code Description


Lip, Lower


Code Description


Lip, Lower


Code Description


Lip, Lower


Code Description


Lip, Lower


Code Description


Lip, Lower


Code Description





Malignant Melanoma of Lower Lip


C00.1, C00.4, C00.6 (M-8720-8790)

C00.0 External upper lip


C00.6 Commissure of lip





















staging website:









Code Description
























Lamina propria

Multiple foci


Vermilion surface


Skin of lip


ERROR NA L L

105 Tumor confined to mucosa of lower lip:


Vermilion surface

T3 NA L L






See code 520

Musculature





Commissure (for lower lip)


T3 NA RE RE


Lower gingiva

Gingiva NOS

T3 NA RE RE

440 Extension via mucosa to upper gingiva T3 NA D RE


Floor of mouth

Tongue

T3 NA D D



Buccal mucosa (inner cheek)

Commissure

ERROR NA RE RE


Gingiva

ERROR NA RE RE

520 Involvement of deep soft tissue or musculature of lower

lip

Soft tissue NOS

T4a NA L L

530 520 + (400 or 410)


lower lip + Mucosal involvement of any structure

in code 400 or 410)

T4a NA RE RE



T4a NA RE RE

550 Involvement of deep tissue or periosteum of lower

gingiva

T4a NA RE RE

700 Cartilage of mandible

Cartilage NOS


Cortical bone NOS

Mandible, NOS

Bone NOS except maxilla, skull base

T4a NA RE RE





705 520, 540, or 700) + 440

(Any structure in code 520 or 540 + Mucosa of upper

gingiva)

T4a NA D RE

710 Deep tissue or periosteum of upper gingiva T4a NA D RE

740 Skin of nose T4a NA RE D

743 740 + (440 or 710)

(Skin of nose + Mucosa or deep tissue upper gingiva)

T4a NA D D

745 (520, 540, 700, 710, or 740) + 450

(Any structure in code 520, 540, 700, 710, or 740 +

Mucosa of floor of mouth or tongue)

T4a NA D D


mouth or tongue


T4a NA D D


Tongue

ERROR NA D D


Genioglossus

Hyoglossus

Palatoglossus

Styloglossus

T4a NA D D


765 Cartilage of maxilla

Cortical bone of maxilla

Maxilla NOS

T4a NA D D



Floor of mouth


ERROR NA D D



Masticator space

Pterygoid plates

Skull base


T4b NA D D



ERROR NA D D






Brain

Dura


Prevertebral space


T4b NA D D


815 Stated as T4 NOS with no other information on

extension

T4NOS NA L L



ERROR NA U U




NA NA U U




Basis 7

Staging

Basis 6




evidence used.

c






c




p





Basis 7

Staging

Basis 6



radiation


radiation performed





classification.

p





c





yp



autopsy)

a



Unknown if assessed


c





extracapsular extension, levels involved, and location above or below the lower border of the criocid cartilage) is

coded in Site-Specific Factors 1, 3-9.












Level I node:

Level IA - Submental(submaxillary),

sublingual

Level IB - Submandibular

Mandibular

Parotid:

Infraauricular

Intraparotid

Periparotid

Preauricular


N1 NA RN RN




Upper deep cervical





Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS


N1 NA D RN







Posterior cervical





Laterotracheal

Paralaryngeal


Perithyroidal

Precricoid ( Delphian)

Prelaryngeal


Recurrent laryngeal



DX)

Esophageal groove



Buccinator (buccal)

Nasolabial

Other groups:

Parapharyngeal

Retroauricular (mastoid)

Retropharyngeal

Suboccipital

N1 NA D D




ERROR NA RN RN



ERROR NA RN RN



ERROR NA D RN



120

ERROR NA D D



ERROR NA RN RN








multiple

ERROR NA RN RN




multiple

ERROR NA D RN




multiple

ERROR NA D D




ERROR NA RN RN




ERROR NA D RN




ERROR NA D D



ERROR NA RN RN




contralateral,


ERROR NA RN RN




contralateral


ERROR NA D RN








contralateral,


ERROR NA D D


Stated as N2, NOS

ERROR NA RN RN



ERROR NA RN RN





NX NA U U




intent.
















Basis 7

Staging

Basis 6





c





Basis 7

Staging

Basis 6


following criteria:




OR





c




p


following criteria:





OR



p





(see code 6).

c





before treatment.

yp



autopsy.

a



Unknown if assessed


c






Code Description











Code Description

















Mediastinal


M1 NA D D






10)

Carcinomatosis

M1 NA D D

50 10 + 40)


M1 NA D D


Stated as M1, NOS

M1 NA D D




M0 NA U U





Basis 7

Staging

Basis 6





negative.

c






c





p







treatment.

p





Basis 7

Staging

Basis 6




evidence.

c




evidence.

yp




a


Unknown if assessed


c




Code Description





See code 980

981-988 millimeters


See code 980











Code Description




















disease."



Code Description









See code 987





988 Not applicable:





Code Description













Code Description





















Code Description






Code Description




















Code Description
























Code Description









































Code Description








988 Not applicable:







this field.










Code Description






Code Description



988 Not applicable:










this field.










Code Description






macroscopic


988 Not applicable:




















Code Description


Negative, NOS





unknown,




unknown,








988 Not applicable:

















Code Description



Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters





988 Not applicable:


990 Microinvasion







Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description




Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description





Other Lip


C00.2, C00.5, C00.8-C00.9 C00.2 External lip, NOS

C00.5 Mucosa of lip, NOS

C00.8 Overlapping lesion of lip

C00.9 Lip, NOS (excludes skin of lip C44.0)





















staging website:







Other Lip




Code Description
















Other Lip


compact outer layer of bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling





or 415.

Note 4: Use codes 405, 410, 415, 778, 810, or 815 if the physician's assignment of T category is the ONLY

information available about the extent of the tumor.









Lamina propria

Multiple foci


Vermilion surface


Skin of lip


^ * L L







Commissure


^ * RE RE

510 Gingiva ^ * RE RE

535 Cortical bone of maxilla

Maxilla, NOS


Mandible, NOS

Cortical bone, NOS (not specified in higher codes)


^ * RE RE

725 Trabecular bone of maxilla or mandible T4a T4a RE RE





Cortical bone

Floor of mouth


ERROR T4a D D


788 Specified bone (other than mandible, maxilla, or bones

in codes 790 and 800)

T4b T4b D D


Pterygoid plates

T4b T4b D D






Skull base


T4b T4b D D



extension

T4NOS T4NOS RE RE





TX TX U U





Other Lip



Basis




c





c




p




performed





p





Basis





c





yp



a



Unknown if assessed


c

Other Lip







ipsilateral.















Level I node:

Level IA - Submental

Level IB - Submandibular (submaxillary),

sublingual

Other groups

Facial

Buccinator (buccal)

Mandibular

Nasolabial

Parotid

Infraauricular

Intraparotid

Periparotid

Preauricular


^ * RN RN



Jugolodigastric (subdigastric)

Upper deep cervical





Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS


^ * D RN







Posterior cervical



supraclavicular (see note 4)

Level VI node - Anterior compartgment group

Laterotracheal

Paralaryngeal


Perithyroidal


Prelaryngeal


Recurrent laryngeal



Esophageal groove



Other groups:

Parapharyngeal

Retroauricular

Retropharyngeal

Suboccipital

^ * D D






100)

^ * D RN



100, 110)

^ * D D




multiple

^ * RN RN



multiple

^ * D RN







multiple

^ * D D



^ * RN RN



WITHOUT any nodes listed in code 100)

^ * D RN



WITHOUT any nodes listed in codes 100, 110)

^ * D D




contralateral,


^ * RN RN



contralateral,


^ * D RN



contralateral,


^ * D D







NX NX U U










Other Lip



intent.
















Basis





c


criteria:




OR




c




p





T category.

OR



p





Basis





c





yp



a



Unknown if assessed


c

Other Lip


Code Description









Other Lip


Code Description







Code Description








Other Lip






Mediastinal


M1 M1 D D


10)

Carcinomatosis

M1 M1 D D

50 (10) + (40)


M1 M1 D D


Stated as M1, NOS

M1 M1 D D




M0 MX U U

Other Lip




Basis





c





Basis





c




autopsy).

p







p




c




yp




a


Unknown if assessed


c

Other Lip



Code Description







Code Description


See code 980

981-988 millimeters


See code 980













Other Lip














disease."



Code Description






Code Description







See code 987





988 Not applicable:






Other Lip








Code Description












Code Description




Other Lip









Code Description












Other Lip










Code Description





Code Description











Other Lip









Code Description




















Code Description








Other Lip














Code Description








988 Not applicable:






Other Lip




this field.










Code Description





988 Not applicable:






Other Lip




this field.










Code Description





Code Description





macroscopic


988 Not applicable:





Other Lip












Code Description


Negative, NOS





unknown,




unknown,






Code Description






988 Not applicable:







Other Lip







Code Description



Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters





988 Not applicable:


990 Microinvasion








Other Lip


Code Description


Other Lip


Code Description


Other Lip


Code Description


Other Lip


Code Description


Other Lip


Code Description


Other Lip


Code Description


Other Lip


Code Description





Malignant Melanoma of Other Lip


C00.2, C00.5, C00.8-C00.9 (M-8720-8790)

C00.2 External lip, NOS

C00.5 Mucosa of lip, NOS

C00.8 Overlapping lesion of lip

C00.9 Lip, NOS (excludes skin of lip C44.0)





















staging website:









Code Description
























Lamina propria

Multiple foci


Vermilion surface


Skin of lip


ERROR NA L L

105 Tumor confined to mucosa of lower lip:


Vermilion surface

T3 NA L L






See code 520

Musculature





Commissure (for lower lip)


T3 NA RE RE


Lower gingiva

Gingiva NOS

T3 NA RE RE




Commissure


ERROR NA RE RE


Gingiva

ERROR NA RE RE

520 Involvement of deep soft tissue or musculature of lower

lip

Soft tissue NOS

T4a NA L L

530 520 + (400 or 410)


lower lip + Mucosal involvement of any structure

in code 400 or 410)

T4a NA RE RE



T4a NA RE RE

550 Involvement of deep tissue or periosteum of lower

gingiva

T4a NA RE RE


mouth or tongue


T4a NA D D


Tongue

ERROR NA D D






Genioglossus

Hyoglossus

Palatoglossus

Styloglossus

T4a NA D D


765 Cartilage NOS

Cortical bone NOS

Bone NOS excluding skull base

T4a NA D D



Floor of mouth


ERROR NA D D



Masticator space

Pterygoid plates

Skull base


T4b NA D D



ERROR NA D D


Brain

Dura


Prevertebral space


T4b NA D D



extension

T4NOS NA L L



ERROR NA U U




NA NA U U







Basis 7

Staging

Basis 6




evidence used.

c






c




p



radiation


radiation performed





classification.

p





c





yp



autopsy)

a





Basis 7

Staging

Basis 6



Unknown if assessed


c





extracapsular extension, levels involved, and location above or below the lower border of the criocid cartilage) is

coded in Site-Specific Factors 1, 3-9.








Level I node:

Level IA - Submental

Level IB - Submandibular (submaxillary),

sublingual

Other groups:

Facial:

Buccinator (buccal)

Mandibular

Nasolabial

Parotid:

Infraauricular

Intraparotid

Periparotid

Preauricular


N1 NA RN RN




Upper deep cervical





Lower deep cervical

Virchow node

Cervical, NOS

Deep cervical, NOS


N1 NA D RN







Posterior cervical





Laterotracheal

Paralaryngeal


Perithyroidal

Precricoid ( Delphian)

Prelaryngeal


Recurrent laryngeal



DX)

Esophageal groove



Other groups:

Parapharyngeal

Retroauricular

Retropharyngeal

Suboccipital

N1 NA D D




ERROR NA RN RN



ERROR NA RN RN



ERROR NA D RN



120

ERROR NA D D



ERROR NA RN RN




multiple

ERROR NA RN RN








multiple

ERROR NA D RN




multiple

ERROR NA D D




ERROR NA RN RN




ERROR NA D RN




ERROR NA D D



ERROR NA RN RN




contralateral,


ERROR NA RN RN




contralateral


ERROR NA D RN




contralateral,


ERROR NA D D


Stated as N2, NOS

ERROR NA RN RN







ERROR NA RN RN





NX NA U U




intent.
















Basis 7

Staging

Basis 6





c


following criteria:




OR





c





Basis 7

Staging

Basis 6




p


following criteria:





OR



p





(see code 6).

c





before treatment.

yp



autopsy.

a



Unknown if assessed


c



Code Description








Code Description







Code Description

















Mediastinal


M1 NA D D


10)

Carcinomatosis

M1 NA D D

50 10 + 40)


M1 NA D D


Stated as M1, NOS

M1 NA D D








M0 NA U U





Basis 7

Staging

Basis 6





negative.

c






c





p







treatment.

p




evidence.

c




evidence.

yp





Basis 7

Staging

Basis 6




a


Unknown if assessed


c




Code Description





See code 980

981-988 millimeters


See code 980






























disease."



Code Description









See code 987





988 Not applicable:

















Code Description





















Code Description










Code Description
















Code Description
























Code Description









































Code Description








988 Not applicable:







this field.










Code Description






Code Description



988 Not applicable:










this field.










Code Description






macroscopic


988 Not applicable:




















Code Description


Negative, NOS





unknown,




unknown,








988 Not applicable:

















Code Description



Examples:

001 0.1 millimeter

010 1 millimeter

042 4.2 millimeters





988 Not applicable:


990 Microinvasion







Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description




Code Description




Code Description







Code Description




Code Description




Code Description




Code Description




Code Description


lip, upper lip (vermilion or labial mucosa) c00.0, c00 · compact outer layer of bone. trabecular,...

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