EOD Regional Nodes

Notes

**Note 1:** **Regional nodes and nodes, NOS** * Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in EOD Mets. **Note 2:** **Unnamed nodes** * **For Colon and Rectum ONLY**, any unnamed nodes that are removed with a colon or rectal resection are presumed to be regional pericolic or perirectal lymph nodes and are included in the EOD Regional Nodes code 300 (pericolic for sites C180 - C189, C199 and perirectal for sites C199 or C209). * This site-specific instruction applies only to colon and rectum tumors and was verified with subject matter experts. **Note 3:** **CLINICAL AND PATHOLOGICAL codes** * This schema has lymph node codes that are defined as **CLINICAL** assessment only or **PATHOLOGICAL** assessment only. * **PATHOLOGICAL** assessment only code (300) is used when * 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 * Pathological code 300 takes priority over codes 350-600, 800 * **CLINICAL** assessment only codes (350-600) are used when the **only** information on nodal involvement is based on **physical exam or imaging** * These codes are specifically for when there is no **microscopic confirmation** of regional lymph nodes (*Regional Nodes Positive = 98, 99*) * **Note:** Use code 300 if *Regional Nodes Positive is 01-90, 95* * Remaining codes (no designation of **CLINICAL** or **PATHOLOGICAL** only assessment) can be used based on clinical and/or pathological information * **Code 000** is used when there is no evidence of regional lymph nodes clinically **OR** lymph nodes are negative pathologically (*Regional Nodes Positive = 00, 98*) * **Code 800** is used when there are positive nodes (clinical or pathological), but the specific lymph nodes or number of positive nodes is unknown (*Regional Nodes Positive = 97*) * **Code 999** is used when the lymph node status is unknown and *Regional Nodes Positive = 99* **Note 4:** **Tumor Deposits** * Code 200 is defined as **PATHOLOGICAL** assessment only. This is used when * Primary tumor or site surgically resected with * Any positive microscopic examination of tumor deposits WITHOUT positive lymph nodes * If there are also positive lymph nodes, code 300
Code Description SS2018 N
000 No regional lymph node involvement and no tumor deposits (TD) NONE
200 **PATHOLOGICAL ASSESSMENT ONLY** Tumor deposits (TD) in the subserosa, mesentery, mesorectal or nonperitonealized pericolic or perirectal tissues **WITHOUT** regional nodal metastasis RN
300 **PATHOLOGICAL ASSESSMENT ONLY** All sites (C180, C182-C189) - Colic, NOS - Epicolic (adjacent to bowel wall) - Mesenteric, NOS - Mesocolic, NOS - Paracolic - Pericolic Cecum (C180) - Cecal, NOS + Anterior cecal (prececal) + Posterior cecal (retrocecal) - Colic (right) - Ileocolic - Periappendiceal Ascending colon (C182) - Colic (middle-right branch, right) - Ileocolic Hepatic flexure (C183) - Colic (middle, right) - Ileocolic Transverse colon (C184) - Colic (middle) Splenic flexure (C185) - Colic (left, middle) - Mesenteric (inferior) Descending colon (C186) - Colic (left) - Mesenteric (inferior) - Sigmoid Sigmoid colon (C187) - Colic (left) - Mesenteric (inferior) - Rectal (superior) (hemorrhoidal) - Rectosigmoid - Sigmoid (sigmoidal) (sigmoid mesenteric) - Superior rectal (hemorrhoidal) Rectosigmoid (C199) - Hemorrhoidal (middle, superior) - Mesenteric (inferior) - Mesorectal - Pericolic - Perirectal - Rectal (middle, superior) - Sigmoid (mesenteric) Rectum (C209) - Hemorrhoidal (middle, superior) - Iliac (hypogastric, internal, obturator) (see EOD Mets for common, external, NOS) - Mesenteric (inferior) - Mesorectal - Perirectal - Rectal (inferior) - Sacral, NOS + Lateral sacral (laterosacral) + Middle sacral (promontorial) (Gerota's node) + Presacral - Sigmoidal (sigmoid mesenteric) RN
350 **CLINICAL ASSESSMENT ONLY** One positive node clinically OR Stated as Clinical N1a RN
400 **CLINICAL ASSESSMENT ONLY** Two-three positive nodes clinically OR Stated as Clinical N1b RN
450 **CLINICAL ASSESSMENT ONLY** Stated as Clinical N1, number of positive nodes clinically unknown RN
500 **CLINICAL ASSESSMENT ONLY** Four-six positive nodes clinically OR Stated as Clinical N2a RN
550 **CLINICAL ASSESSMENT ONLY** Seven or more positive nodes clinically OR Stated as Clinical N2b RN
600 **CLINICAL ASSESSMENT ONLY** Stated as Clinical N2, number of positive nodes clinically unknown RN
800 Positive nodes, number unknown Unknown if clinical or pathological assessment Regional lymph node(s), NOS Lymph node(s), NOS RN
999 Unknown; regional node(s) not stated Regional lymph node(s) cannot be assessed Not documented in medical record Death Certificate Only U
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