**Note 1:** Peritoneal spread is common in appendiceal tumors and is coded as 30 if limited to the peritoneum. Peritoneal implants involving abdominopelvic organs, such as the serosa of the small or large bowel and the surface of the ovary, spleen, or liver, should be coded as 30, regardless of whether implants demonstrate infiltration of underlying tissue, manifested as invasion. Nonperitoneal metastasis, such pleuropulmonary involvement is rare and would be coded as 50.
**Note 2:** Use code 70 when the only information is “distant metastasis, NOS,” and there is no documentation regarding the specific metastases.
* If there are specific metastasis documented that are not listed in codes 10, 30, 40, or 50, assign code 50 for “other specified distant metastasis.”
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(3) Collaborative Stage Work Group of the American Joint Committee on Cancer. **Collaborative Stage Data Collection System User Documentation and Coding Instructions, version 02.05**. American Joint Committee on Cancer (Chicago, IL)
(4) Gress, D.M., Edge, S.B., Gershenwald, J.E., et al. **Principles of Cancer Staging**. In: Amin, M.B., Edge, S.B., Greene, F.L., et al. (Eds.) AJCC Cancer Staging Manual. 8th Ed. New York: Springer; 2017
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