Lymph Nodes Head and Neck Levels IV-V
**Note 1:** Physician statement of Levels IV-V lymph node involvement can be used to code this data item when no other information is available.
**Note 2:** Head and Neck Lymph Node Involvement is coded in the following data items
* LN Head and Neck Levels I-III (NAACCR Data Item #3876)
* LN Head and Neck Levels IV-V (NAACCR Data Item #3877)
* LN Head and Neck Levels VI-VII (NAACCR Data Item #3878)
* LN Head and Neck Other (NAACCR Data Item #3879)
**Note 3:** Code the presence or absence of lymph node involvement for Levels IV-V
* For more information on Levels IV-V lymph nodes, see AJCC 8th edition, Chapter 5: *Staging Head and Neck Cancers*, Table 5.1
**Note 4:** 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, or is documented as supraclavicular with no further information, code them as Level V nodes
**Note 5:** Pathological information takes priority over clinical.
**Note 6:** If involved regional node levels are documented as a range, and/or if the involved nodes overlap multiple levels, code all levels specified.
**Note 7:** If information is available on some nodes, but the others are unknown, code what is known.
* ***Example:*** Multiple lymph nodes involved, level V documented, but the other levels not mentioned. Code 2 to indicate level V involvement.