EOD Regional Nodes

Notes

**Note 1:** Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets. **Note 2:** This schema has lymph node codes that are defined as **CLINICAL** assessment only or **PATHOLOGICAL** assessment only. + **CLINICAL** assessment only codes (100, 200, 600, 650) are used when there is a clinical work up only and there is no surgical resection of the primary tumor or site. This includes FNA, core biopsy, sentinel node biopsy, or lymph node excision - *Exception:* If patient has neoadjuvant therapy, and the clinical assessment is greater than the pathological assessment, then the clinical assessment code would take priority + **PATHOLOGICAL** assessment only codes (300, 350, 400, 500, 700, 750) are used when - Primary tumor or site surgically resected with - Any microscopic examination of regional lymph nodes. Includes - FNA, core biopsy, sentinel node biopsy or lymph node excision done during the clinical work up and/or - Lymph node dissection performed + Remaining codes (no designation of **CLINICAL** or **PATHOLOGICAL** only assessment) can be used based on clinical and/or pathological information **Note 3:** Isolated tumor cells (ITCs) are defined as single tumor cells or small clusters not greater than 0.2 mm, usually detected by immunohistochemical (IHC) or molecular methods. ITCs do not usually show evidence of malignant activity (e.g., proliferation or stromal reaction). * Lymph nodes with isolated tumor cells (ITCs) are counted as positive lymph nodes **Note 4:** In transit metastasis is defined as a tumor distinct from the primary lesion and located either between the primary lesion and the draining regional lymph node(s) or distal to the primary lesion. In transit metastasis with positive lymph node(s) are coded under regional lymph nodes. * Code 600 if there are **clinically** in-transit metastasis WITHOUT regional lymph node involvement * Code 650 if there are **clinically** in-transit metastasis WITH regional lymph node involvement * Code 700 if there are **pathologically** in-transit metastasis WITHOUT regional lymph node involvement * Code 750 if there are **pathologically** in-transit metastasis WITH regional lymph node involvement **Note 5:** Regional lymph nodes for skin * Single, Multiple, Ipsilateral, Bilateral or Contralateral lymph nodes **Skin of head and neck (C000-C006, C008-C009, C440-C444)** - Levels I-VII - Axillary (neck only, C444) - Cervical, NOS - Deep cervical, NOS - Facial (buccinator, buccal, nasolabial) - Internal jugular, NOS - Parapharyngeal - Parotid (infraauricular, intraparotid, periparotid, preauricular) - Retroauricular (mastoid) - Retropharyngeal - Suboccipital **Skin of trunk (C445)** - Upper trunk + Axillary + Cervical + Internal mammary + Supraclavicular - Lower trunk + Superficial inguinal (femoral) **Skin of upper limb and shoulder (C446)** - Axillary - Cervical - Epitrochlear for hand/forearm - Internal mammary (parasternal) - Spinal accessory for shoulder - Supraclavicular (transverse cervical) **Skin of lower limb and hip (C447)** - Femoral (superficial inguinal) - Inguinal - Popliteal for heel and calf **Vulva (C510-C512, C518-C519)** - Deep inguinal, NOS - Femoral - Inguinal, NOS - Inguinofemoral (groin) - Node of Cloquet or Rosenmuller (highest deep inguinal) - Superficial inguinal (femoral) **Penis (C600-C602, C608-C609)** - Iliac, NOS + External + Internal (hypogastric, obturator) - Inguinal, NOS + Node of Cloquet or Rosenmuller (highest deep inguinal) + Superficial [femoral] - Pelvic, NOS **Scrotum (C632)** - Iliac, NOS + External + Internal (hypogastric), NOS * Obturator - Inguinal, NOS + Deep inguinal, NOS * Node of Cloquet or Rosenmuller (highest deep inguinal) + Superficial inguinal (femoral) **Note 6:** Code 800 if regional lymph nodes are involved, but there is no indication which ones are involved.
Code Description SS2018 N
000 No regional lymph node metastasis detected on clinical AND/OR radiologic examination, (sentinel node) biopsy or lymph node dissection NONE
100 CLINICAL assessment only Clinical and/or radiologic exam positive nodes - WITHOUT biopsy or resection of lymph nodes RN
200 CLINICAL assessment only Clinically positive nodes on core biopsy/FNA - WITHOUT sentinel lymph node biopsy or resection of lymph nodes RN
300 PATHOLOGICAL assessment only Clinically occult nodes - WITH positive nodes from sentinel node biopsy RN
350 PATHOLOGICAL assessment only Clinically occult nodes - WITH positive nodes on lymph node resection RN
400 PATHOLOGICAL assessment only Clinically and/or radiologically positive nodes - WITH positive nodes on biopsy or lymph node resection RN
500 PATHOLOGICAL assessment only Clinically unknown if positive or negative - WITH positive nodes on biopsy or lymph node resection RN
600 CLINICAL assessment only In-transit metastasis present - WITHOUT lymph node metastasis or UNKNOWN Discontinuous from primary tumor Located between primary tumor and draining regional nodal basin OR distal to the primary tumor RN
650 CLINICAL assessment only Code 600 WITH lymph node metastasis RN
700 PATHOLOGICAL assessment only In-transit metastasis present - WITHOUT lymph node metastasis or UNKNOWN Discontinuous from primary tumor Located between primary tumor and draining regional nodal basin OR distal to the primary tumor RN
750 PATHOLOGICAL assessment only Code 700 WITH lymph node metastasis RN
800 Regional lymph node(s), NOS Lymph node(s), NOS RN
999 Unknown; regional lymph node(s) not stated Regional lymph node(s) cannot be assessed Not documented in medical record Death Certificate Only U
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