Collaborative Stage Manual Part II - Pacific Cancer Programs · Collaborative Stage Data Collection...

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 - Salivary Glands - 1 Version 02.02.00

Parotid Gland

C07.9 C07.9 Parotid gland

Note: Laterality must be coded for C07.9.

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 CS Site-Specific Factor 11 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

Parotid Gland

CS Tumor Size (Revised: 07/29/2009) Note 1: Code the specific tumor size as stated in the medical record. Use code 992 or 994 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)




Code Description

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

993 Described as "less than 3 cm," or "greater than 2 cm," or "between 2 cm and 3 cm"




996 Described as "greater than 5cm"

999 Unknown; size not stated

Not documented in patient record

Parotid Gland

CS Extension (Revised: 11/15/2009) Note 1: AJCC considers "in situ carcinoma of salivary gland" an impossible diagnosis. Any case so coded will be

mapped to an unknown AJCC stage, in situ Summary Stage.

Note 2: Periosteum is a fibrous membrane that wraps the outer surface of bones. Mucoperiosteum is a compound

structure of mucous membrane and periosteum. Cortical bone is the dense compact outer layer of bone.

Note 3: Use code 300 for localized tumor ONLY if no information is available to assign codes 100, 305, or 310.

Note 4: Use code 305, 310, 410, 725, 810, or 815 if the physician's assignment of T category is the ONLY

information available about the extent of the tumor.

Code Description TNM 7 TNM 6 SS77 SS2000

000 In situ; non-invasive; intraepithelial TX TX IS IS

100 Invasive tumor confined to gland/duct of origin

Multiple foci confined to substance of parotid gland

^ * L L

300 Localized, NOS ^ * L L

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


350 Microscopic extraparenchymal extension ONLY

to periglandular soft/connective tissue

^ * RE RE





400 Macroscopic extraparenchymal extension to:

Periglandular soft/connective tissue

Another major salivary gland (submaxillary,

sublingual)

Pharyngeal mucosa

Skeletal muscle:

Digastric

Masseter

Pterygoid

Sternocleidomastoid

Stylohyoid

T3 T3 RE RE

402 Maxillary artery

Facial artery or vein

T3 T3 RE RE

405 Spinal accessory nerve T3 T3 RE D

408 Stated as T3 with no other information on extension T3 T3 RE RE

420 External auditory meatus

Skin overlying gland

T4a T4a RE RE

450 Periosteum of mandible T4a T4a RE RE

500 Auricular nerve

Mandible

Mastoid process

T4a T4a RE RE

510 (420-500) + 405 (Any structure in codes 420-500 +

Spinal accessory nerve)

T4a T4a RE D

700 Facial (7th) nerve T4a T4a RE D

720 OBSOLETE DATA CONVERTED V0200

Moved to code 405 to correct AJCC mapping

Spinal accessory nerve

ERROR ERROR ERROR ERROR

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

740 Carotid artery (encased)

Jugular vein

T4b T4b RE RE

750 OBSOLETE DATA RETAINED V0200

Note: Maxillary artery, Facial artery or vein moved to

code 402 to correct AJCC mapping

Major blood vessel(s):

Carotid artery


Jugular vein

Maxillary artery

ERROR T4b RE RE

755 740 + 405

(Any structure in code 740 + Spinal accessory)

T4b T4b RE D





758 740 + 700

(Any structure in code 740 +Facial nerve)

T4b T4b RE D

760 Base of skull

Skull, NOS

T4b T4b RE D

770 Pterygoid plates T4b T4b D D

800 Further contiguous extension T4b T4b D D

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

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 100-350 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 100-350 ONLY, the T category for AJCC 6th Edition staging is assigned based on the value

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

Parotid Gland

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

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





Basis

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




Parotid Gland

CS Lymph Nodes (Revised: 10/13/2009) 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: Submental and Cervical nodes NOS moved from code 100 in CSV1 to code 110, Facial and Deep cervical

nodes NOS moved from code 100 in CSV1 to code 120, Levels II, II, and IV nodes moved from code 110 in CSV1

to code 120.


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

100 Single positive ipsilateral regional node:

Level I node

Level IB -

Submandibular (submaxillary), sublingual

Parotid:

Infraauricular

Intraparotid

Periparotid

Preauricular

Regional lymph node, NOS

^ * RN RN


Level I

Level IA node - Submental Cervical NOS

^ * D RN






Level II node - Upper jugular

Upper deep cervical

Level III node - Middle jugular

Middle deep cervical

Level IV node - Lower jugular

Lower deep cervical

Virchow node

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 mediatinal group (for

other mediastinal nodes see CS Mets at DX)

Esophageal groove

Paratracheal - below suprasternal notch

Pretracheal - below suprasternal notch

Other groups:

Facial:

Buccinator (buccal)

Mandibular

Nasolabial

Parapharyngeal

Retroauricular

Retropharyngeal

Suboccipital Deep cervical NOS

^ * 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

210 Multiple positive ipsilateral nodes, any listed in code

110 (WITH or WITHOUT nodes listed in code

100)

^ * D RN


120 (WITH or WITHOUT nodes listed in code 100

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

^ * D RN



multiple

^ * D D


Positive bilateral or contralateral nodes

^ * RN RN

410 Regional lymph nodes, any listed in code 110:

Positive bilateral or contralateral nodes (WITH or

WITHOUT nodes listed in code 100)

^ * D RN



WITHOUT nodes listed in code 100 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

510 Regional lymph nodes as listed in code 110:


contralateral,


^ * D RN



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 node(s) 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






Parotid Gland

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

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





Basis

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

Parotid Gland

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





Parotid Gland

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


Parotid Gland

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




Parotid Gland

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

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




Parotid Gland

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


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"

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

Unknown if regional lymph node(s) involved





Parotid Gland

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

Regional lymph nodes cannot be assessed





Parotid Gland

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



Parotid Gland

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




Parotid Gland

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







Parotid Gland

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







Parotid Gland

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

Parotid Gland

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

Parotid Gland

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




Parotid Gland

CS Site-Specific Factor 10 (Revised: 06/30/2008)

Code Description

988 Not applicable for this schema

Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description





Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description


Parotid Gland


Code Description





Parotid Gland


Code Description


Parotid Gland


Code Description





Submandibular Gland

C08.0 C08.0 Submandibular gland



















staging website:




Submandibular Gland




Code Description






Code Description













Submandibular Gland





Note 3: Use code 300 for localized tumor ONLY if no information is available to assign codes 100, 305, or 310.

Note 4: Use code Use code 305, 310, 408, 625, 810, or 815 if the physician's assignment of T category is the

ONLY information available about the extent of the tumor.



100 Invasive tumor confined to gland/duct of origin ^ * L L






^ * RE RE





400 Macroscopic extraparenchymal extension to

periglandular soft/connective tissue

Another major salivary gland (parotid, sublingual)

Skeletal muscle:

Digastric

Genioglossus

Geniohyoid

Hyoglossus

Mylohyoid

Pterygoid

Styloglossus

Stylohyoid

T3 T3 RE RE



T3 T3 RE RE

405 Spinal accessory nerve T3 T3 D D



500 Mandible

Nerves:

Facial (7th)nerve

Lingual nerve

T4a T4a RE RE

505 (450 or 500) + 405 (Any structure in 450 or 500 +


T4a T4a D D

510 External auditory meatus T4a T4a D D


Move to other codes to correct AJCC mapping, see

code 402 and 650

Major blood vessels:

Carotid artery


Maxillary artery

ERROR T4b RE RE

600 Skin overlying gland T4a T4a D D


650 Blood vessels:

Carotid artery (encased)

T4b T4b RE RE

660 650 + (405, 510, or 600)

(Carotid artery + Any structures in code 405, 510, or

600)

T4b T4b D D

710 Base of skull

Skull, NOS

T4b T4b RE D






Moved to code 405 for AJCC mapping





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

815 Stated as T4NOS with no other information on

extension

T4NOS T4NOS RE RE





TX TX U U

^ For Extension codes 100-350 ONLY, the T category for AJCC 7th Edition staging is assigned based on value of

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

* For Extension codes 100-350ONLY, the T category for AJCC 6th Edition staging is assigned based on value of


Submandibular Gland



Basis




c





c




p





Basis




performed





p





c





yp



a



Unknown if assessed


c

Submandibular Gland







ipsilateral.















Level I node

Level IA - Submental

Level IB - Submandibular (submaxillary)


Jugulodigastric (subdigastric)

Upper deep cervical

Level IIA

Level IIB



Cervical, NOS

Deep cervical, NOS

Internal jugular, NOS


^ * RN RN



Lower deep cervical

Virchow node

Level V node -

Posterior triangle group



supraclavicular


Laterotracheal

Paralaryngeal



Prelaryngeal


Recurrent laryngeal

Level VII node - Superior mediastinal group (for other

mediastinal nodes see CS Mets at DX)

Esophageal groove



Other groups:

Facial:

Buccinator (buccal)

Mandibular

Nasolabial

Parotid:

Infraauricular

Intraparotid

Periparotid

Parapharyngeal

Retroauricular

Retropharyngeal

Suboccipital

^ * D D










100)

^ * D D




multiple

^ * RN RN



multiple

^ * D D



^ * RN RN




^ * D D




contralateral,


^ * RN RN



contralateral,


^ * D D



800 Lymph nodes, NOS ^ * RN RN




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


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

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





Submandibular Gland



intent.
















Basis





c


criteria:




OR




c




p





T category.

OR



p





Basis





c





yp



a



Unknown if assessed


c

Submandibular Gland


Code Description









Submandibular Gland


Code Description







Code Description








Submandibular Gland

CS Mets at DX (Revised: 03/30/2009) Note: Supraclavicular and transverse cervical lymph nodes are now coded in the CS Lymph Nodes table because

they are categorized as N rather than M in AJCC TNM.



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


Stated as M1, NOS

M1 M1 D D




M0 MX U U

Submandibular Gland




Basis





c





Basis





c




autopsy).

p







p




c




yp




a


Unknown if assessed


c

Submandibular Gland



Code Description







Code Description


See code 980

981-988 millimeters


See code 980













Submandibular Gland














disease."



Code Description






Code Description







See code 987





988 Not applicable:






Submandibular Gland








Code Description












Code Description




Submandibular Gland









Code Description












Submandibular Gland










Code Description





Code Description











Submandibular Gland









Code Description




















Code Description








Submandibular Gland














Code Description








988 Not applicable:






Submandibular Gland




this field.










Code Description





988 Not applicable:






Submandibular Gland




this field.










Code Description





Code Description





macroscopic


988 Not applicable:





Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description





Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description





Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description


Submandibular Gland


Code Description





Other and Unspecified Major Salivary Glands

C08.1, C08.8-C08.9 C08.1 Sublingual gland

C08.8 Overlapping lesion of major salivary glands

C08.9 Major salivary gland, NOS



















staging website:








Code Description





Code Description



















Note 3: Use code 300 for localized tumor ONLY if no information is available to assign codes 100 or 305.

Note 4: Use code 305, 310, 408, 625, 810, or 815 if the physician's assignment of T category is the ONLY

information available about the extent of the tumor. if the physician's assignment of T category is the ONLY

information available about the extent of the tumor.



100 Invasive tumor confined to gland/duct of origin ^ * L L






^ * RE RE





400 Macroscopic extraparenchymal extension to

periglandular soft/connective tissue

Another major salivary gland (parotid, submandibular)

Skeletal muscle:

Digastric

Pterygoid

Stylohyoid

T3 T3 RE RE



T3 T3 RE RE

405 Spinal accessory nerve T3 T3 D D



505 450 or 510) + 405 (Any structure in code 450 or 510 +


T4a T4a D D

510 Mandible

Nerves:

Facial (7th)

Lingual

T4a T4a RE RE

600 Skin T4a T4a D D

620 External auditory meatus T4a T4a D D



Blood vessel(s):

Carotid artery


Maxillary artery

Note: Structures moved to correct AJCC mapping

ERROR T4b RE RE

655 Carotid artery (encased) T4b T4b RE RE

660 655 + (450, 600, or 620)

(Carotid artery + Any structures in codes 450, 600, or

620)

T4b T4b D D

710 Base of skull

Skull, NOS

T4b T4b RE D


Moved to code 405 for AJCC mapping









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





TX TX U U

^For Extension codes 100-350 ONLY, the T category for AJCC 7th Edition staging is assigned based on value of


*For Extension codes 100-350 ONLY, the T category for AJCC 6th Edition staging is assigned based on value of





Basis




c





c




p




performed





p





Basis





c





yp



a



Unknown if assessed


c








ipsilateral.








Note 6: Level II and Level III nodes moved from code 120 in CSv1 to code 100.








Level I node

Level IA - Submental

Level IB - Submandibular (submaxillary)


Jugulodigastric (subdigastric)

Upper deep cervical

Level IIA

Level IIB



Other groups:

Parotid

Infra-auricular

Intraparotid

Periparotid

Preauricular

Cervical, NOS


^ * RN RN







Lower deep cervical

Virchow node

Level V node -

Posterior triangle group

Posterior cervical



supraclavicular


Laterotracheal

Paralaryngeal


Perithyroidal


Prelaryngeal


Recurrent laryngeal

Level VII node - Superior mediastinal group (for

other mediastinal nodes see CS Mets at DX)

Esophageal groove



Other groups:

Facial:

Buccinator (buccal)

Mandibular

Nasolabial

Parotid:

Infraauricular

Intraparotid

Periparotid

Preauricular

Parapharyngeal

Retroauricular

Retropharyngeal

Sublingual

Suboccipital

^ * D D






100)

^ * D D




multiple

^ * RN RN







multiple

^ * D D



^ * RN RN




^ * D D




contralateral,


^ * RN RN



contralateral,


^ * D D



800 Lymph nodes, NOS ^ * RN RN




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


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


Nodes Size Table for this site.







intent.
















Basis





c


criteria:




OR




c




p





T category.

OR



p





Basis





c





yp



a



Unknown if assessed


c



Code Description











Code Description







Code Description









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.



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


Stated as M1, NOS

M1 M1 D D




M0 MX U U





Basis





c





Basis





c




autopsy).

p







p




c




yp




a


Unknown if assessed


c




Code Description







Code Description


See code 980

981-988 millimeters


See code 980



























disease."



Code Description






Code Description







See code 987





988 Not applicable:














Code Description












Code Description













Code Description






















Code Description





Code Description




















Code Description




















Code Description






















Code Description








988 Not applicable:










this field.










Code Description





988 Not applicable:










this field.










Code Description





Code Description





macroscopic


988 Not applicable:







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




Code Description




Code Description


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