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 * 3876: LN Head and Neck Levels I-III * 3877: LN Head and Neck Levels IV-V * 3878: LN Head and Neck Levels VI-VII * 3879: LN Head and Neck Other **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.




NAACCR #3877


Code Description
0 No involvement in Levels IV or V lymph nodes Non-invasive neoplasm (behavior /2)
1 Level IV lymph node(s) involved
2 Level V lymph node(s) involved
3 Levels IV and V lymph node(s) involved
8 Not applicable: Information not collected for this case (If this item is required by your standard setter, use of code 8 will result in an edit error)
9 Not documented in medical record Positive nodes, but level of positive node(s) unknown Lymph node levels IV-V not assessed, or unknown if assessed