]> M-8247 C44.0 Skin of lip, NOS C44.2 External ear C44.3 Skin of ear and unspecified parts of face C44.4 Skin of scalp and neck C44.5 Skin of trunk C44.6 Skin of upper limb and shoulder C44.7 Skin of lower limb and hip C44.8 Overlapping lesion of skin C44.9 Skin, NOS Note 1: This schema is NOT used for Merkel cell carcinoma of the vulva, penis, or scrotum. Each of these has a separate schema. Note 2: Laterality must be coded for C44.2-C44.3 and C44.5-C44.7. For codes C44.3 and C44.5, if the tumor is midline (e.g., chin), code 5 (midline) in the laterality field. Note 3: Merkel cell carcinoma presenting in nodal or visceral site with primary site unknown is coded to C44.9, Skin, NOS. &commontumorsizeskinmerkel; CS Extension Note 1: In the case of multiple simultaneous tumors, code the tumor with the greatest extension. Note 2: Skin ulceration does not alter the AJCC T category. Note 3: In-transit metastasis is coded in CS Lymph Nodes. Note 4: The assignment of the T1, T2, and T3 categories for Merkel cell carcinomas is based on tumor size. A physician's statement of the T category may be used to code both CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently; for example, the record may document size but not extension. Use codes 600, 610, 620, and 810 as appropriate to code CS Extension based on a statement of T when no other extension information is available. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 Tis Tis IS IS 100 Lesion(s) confined to dermis ^ * L L 400 Localized, NOS ^ * L L 500 Subcutaneous tissue (through entire dermis) ^ * L L 600 Stated as T1 with no other information on extension ^ * L L 610 Stated as T2 with no other information on extension ^ * L L 620 Stated as T3 with no other information on extension ^ * L L 680 Fascia T4 T4 D RE 700 Underlying cartilage, bone, skeletal muscle T4 T4 D RE 800 Further contiguous extension T4 T4 D D 810 Stated as T4 with no other information on extension T4 T4 D D 950 No evidence of primary tumor T0 T0 U U 999 TX TX U U ^ For CS Extension codes 100, 400, 500, 600, 610, and 620 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size as shown in the Extension Size Table for this schema. * For CS Extension codes 100, 400, 500, 600, 610, and 620 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size as shown in the Extension Size Table for this schema. &generalcstsexteval; CS Lymph Nodes Note 1: Code only regional nodes and nodes, NOS, in this field. Distant nodes are coded in CS Mets at DX. Note 2: Bilateral or contralateral nodes are considered regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy. Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed. Note 3: Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are considered regional for AJCC staging but may be distant for Summary Stage. Use code 250 for involvement of nodes in secondary nodal basins not specified in codes 100 and 200. 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 nodes or distal to the primary lesion. In-transit metastasis is coded in CS Lymph Nodes. Note 5: Isolated tumor cells (ITCs) should be considered positive nodes. If only ITCs are present, use code 010. Note 6: If the only information about lymph nodes is a statement of N1 involvement without a clinical or pathologic designation, use code 370. Code Description TNM 7 Map TNM 6 Map SS77 Map SS2000 Map 000 No regional lymph node involvement N0 N0 NONE NONE 010 Isolated tumor cells (ITCs) only ^ N0 NONE NONE 100 ^ N1 RN RN 200 ^ N1 D RN 250 ^ N1 D D 300 ^ N1 D RN 305 ^ N1 D D 310 ^ N1 RN RN 320 ^ N1 RN RN 340 ^ N1 RN RN 350 ^ N1 RN RN 360 Stated as N1[NOS] with no information on pathologic or clinical evaluation ^ N1 RN RN 390 N2 N0 RE RE 400 N2 N1 RE RN 420 N2 N1 RN RN 440 N2 N1 D RN 460 N2 N1 D RN 470 N2 N1 D D 475 N2 N1 RN RN 480 N2 N1 RE RE 800 Lymph nodes, NOS N1NOS N1 RN RN 999 NX NX U U ^ When CS Lymph Nodes Eval is coded, for CS Lymph Nodes codes 010-370 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Status of Lymph Node Mets, as shown in the Lymph Nodes and Nodal Status Eval AJCC 7 Table. When CS Lymph Nodes Eval is blank, for CS Lymph Nodes codes 010-370 ONLY, the N category for AJCC 7 staging is assigned based on the value of CS Site-Specific Factor 3, Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Eval Blank AJCC 7 Table. &commonregnodesevalmerkelcell; &commonreglnpos_active; &generalreglnexam; &commonmetsatdxmerkelcellscrotum; &generalmetseval; &commonssf1merkelcell; ¬appssfactor2; &commonssf3merkelcell; ¬appssfactor4; ¬appssfactor5; ¬appssfactor6; ¬appnewssf7; ¬appnewssf8; ¬appnewssf9; ¬appnewssf10; ¬appnewssf11; ¬appnewssf12; ¬appnewssf13; ¬appnewssf14; ¬appnewssf15; &commonssf16merkelcell; &commonssf17merkelcell; &commonssf18merkelcell; &commonssf19merkelcell; &commonssf20merkelcell; &commonssf21merkelcell; &commonssf22merkelcell; ¬appnewssf23; ¬appnewssf24; ¬appnewssf25; &commonhistinclusionskinmerkelcell; &commonhistologyexclusions1; &commonstagemerkelcelltnm7; AJCC TNM 6 Stage T N M Stage T0 N0 M0 ERROR T0 N1 M0 III T0 NX M0 UNK T0 N0 M1 IV T0 N1 M1 IV T0 NX M1 IV T0 N0 MX UNK T0 N1 MX UNK T0 NX MX UNK Tis N0 M0 0 Tis N1 M0 ERROR Tis NX M0 0 Tis N0 M1 ERROR Tis N1 M1 ERROR Tis NX M1 ERROR Tis N0 MX 0 Tis N1 MX ERROR Tis NX MX 0 T1 N0 M0 I T1 N1 M0 III T1 NX M0 UNK T1 N0 M1 IV T1 N1 M1 IV T1 NX M1 IV T1 N0 MX UNK T1 N1 MX UNK T1 NX MX UNK T2 N0 M0 II T2 N1 M0 III T2 NX M0 UNK T2 N0 M1 IV T2 N1 M1 IV T2 NX M1 IV T2 N0 MX UNK T2 N1 MX UNK T2 NX MX UNK T3 N0 M0 II T3 N1 M0 III T3 NX M0 UNK T3 N0 M1 IV T3 N1 M1 IV T3 NX M1 IV T3 N0 MX UNK T3 N1 MX UNK T3 NX MX UNK T4 N0 M0 III T4 N1 M0 III T4 NX M0 III T4 N0 M1 IV T4 N1 M1 IV T4 NX M1 IV T4 N0 MX UNK T4 N1 MX UNK T4 NX MX UNK TX N0 M0 UNK TX N1 M0 III TX NX M0 UNK TX N0 M1 IV TX N1 M1 IV TX NX M1 IV TX N0 MX UNK TX N1 MX UNK TX NX MX UNK &commonsummarystage; Extension Size Table Note: For CS Extension codes 100, 400, 500, 600, 610, and 620 ONLY, the T category is assigned based on the value of CS Tumor Size, as shown in this table. CS Extension CS Tumor Size 000 0 CS Tumor Size 001-020 1 20 CS Tumor Size 021-050 21 50 CS Tumor Size 051-989 51 989 CS Tumor Size 990-991 990 991 CS Tumor Size 992 992 CS Tumor Size 993-994 993 994 CS Tumor Size 995 995 CS Tumor Size 996 996 CS Tumor Size 999 999 100 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 400 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 500 ERROR T1 T2 T3 T1 T1 T2 T2 T3 TX 600 ERROR T1 T2 T3 T1 T1 T2 T2 T3 T1 610 ERROR T1 T2 T3 T1 T2 T2 T2 T3 T2 620 ERROR T1 T2 T3 T1 T3 T3 T3 T3 T3 Lymph Node and Nodal Status Eval AJCC 7 Table Note: For CS Lymph Nodes codes 010-360 ONLY, the N category is assigned based on the value of CS Lymph Nodes Eval and CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, as shown in the following table. CS Lymph Nodes Eval CS Lymph Nodes CS SSF 3 000, 005 0 5 CS SSF 3 010 10 CS SSF 3 020 20 CS SSF 3 100 100 CS SSF 3 150 150 CS SSF 3 888, 988 888 988 CS SSF 3 999 999 0,1,5,9 010 ERROR N1a N1b ERROR N2 ERROR N1a 0,1,5,9 100-360 ERROR ERROR N1 ERROR N2 ERROR N1 2,3,6,8 010 ERROR N1a N1b ERROR ERROR ERROR N1a 2,3,6,8 100-310 ERROR N1a N1b ERROR N2 ERROR N1NOS 2,3,6,8 320 ERROR N1a N1b ERROR N2 ERROR N1a 2,3,6,8 340 ERROR N1a N1b ERROR N2 ERROR N1b 2,3,6,8 350,360 ERROR N1a N1b ERROR N2 ERROR N1NOS Lymph Node and Nodal Status Eval Blank AJCC 7 Table Note: When CS Lymph Nodes Eval is blank, for CS Lymph Nodes codes 010-360 ONLY, the N category is assigned based on the value of CS Site-Specific Factor 3, Clinical Status of Lymph Node Mets, and Regional Nodes Positive, as shown in the following table. Regional Nodes Positive CS Lymph Nodes CS SSF 3 000, 005 0 5 CS SSF 3 010 10 CS SSF 3 020 20 CS SSF 3 100 100 CS SSF 3 150 150 CS SSF 3 888, 988 888 988 CS SSF 3 999 999 00,98 010 ERROR N1a N1b ERROR N2 ERROR N1a 00,98 100-360 ERROR N1 N1 ERROR N2 ERROR N1 01-90,95,97,99 010 ERROR N1a N1b ERROR N2 ERROR N1a 01-90,95,97,99 100-305 ERROR N1a N1b ERROR N2 ERROR N1NOS 01-90,95,97,99 310 ERROR N1a N1b ERROR N2 ERROR N1 01-90,95,97,99 320 ERROR N1a N1b ERROR N2 ERROR N1a 01-90,95,97,99 340 ERROR N1a N1b ERROR N2 ERROR N1b 01-90,95,97,99 350 ERROR N1a N1b ERROR N2 ERROR N1NOS 01-90,95,97,99 360 ERROR N1a N1b ERROR N2 ERROR N1NOS