Q.1: SKIN

For Cases Diagnosed prior to January 1, 2003

C44.0-C44.9
SURGICAL APPROACH

 

Code

Description

0

None; no cancer-directed surgery of primary site

4

Open approach

9

Death certificate only

 

SURGERY OF PRIMARY SITE

 

Code

Description

00

None; no cancer-directed surgery of primary site

10

Local tumor destruction, NOS

Note: without pathology specimen.

11

 

Photodynamic therapy (PDT)

12

 

Electrocautery; fulguration

Note: Includes use of hot forceps for tumor destruction.

13

 

Cryosurgery

14

 

Laser ablation

Note: No specimen sent to pathology from this surgical event.

20

Local tumor excision, NOS

Note: With pathology specimen.

21

 

Photodynamic therapy (PDT)

22

 

Electrocautery

23

 

Cryosurgery

24

 

Laser ablation

25

 

Laser excision

26

 

Polypectomy

27

 

Excisional biopsy

Note: Specimen sent to pathology from this surgical event.

30

Biopsy of primary tumor followed by a gross excision of the lesion

31

 

Shave biopsy followed by a gross excision of the lesion

32

 

Punch biopsy followed by a gross excision of the lesion

33

 

Incisional biopsy followed by a gross excision of the lesion

Note: Less than a wide excision, less than 1 cm margin.

40

Wide excision or reexcision of lesion or minor (local) amputation, NOS

Note: Margins of excision are 1 cm or more. Margins may be microscopically involved. Local amputation is the surgical resection of digits, ear, eyelid, lip, or nose.

50

Radical excision of a lesion, NOS

Note: Margins of excision are greater than 1 cm and grossly tumor free. The margins may be microscopically involved.

60

Major amputation, NOS

90

Surgery, NOS

99

Unknown if cancer-directed surgery performed; death certificate only

 

SURGICAL MARGINS

 

Code

Description

0

All margins grossly and microscopically negative

1

Margins involved, NOS

2

 

Microscopic involvement

5

 

Macroscopic involvement

7

Margins not documented

8

No cancer-directed surgery of primary site

9

Unknown whether margins were involved or negative; death certificate only

 

SCOPE OF REGIONAL LYMPH NODE SURGERY

Regional lymph nodes are different for each anatomical subsite.

 

Site

Subsite

Head, neck

  • Cervical

  • Ipsilateral preauricular

  • Submandibular

  • Supraclavicular

Thorax

Ipsilateral axillary

Arm     

Ipsilateral epitrochlear and axillary

Abdomen, loins, and buttocks

Ipsilateral inguinal

Anal margin and perianal skin

Ipsilateral inguinal

Leg

Ipsilateral inguinal and popliteal

 

There are boundary zones between the subsites (i.e., between the thorax and arm, the boundary zone is the shoulder and axilla).  The boundary zones do not belong to either subsite.  If a tumor originates in one of these 4 cm boundary zones, the nodes on either side of the bands are regional.

 

Between the Subsites

The Boundary Zone is

Head and neck AND

Thorax

Clavicula-acromion-upper shoulder blade edge

Thorax AND

Arm

Shoulder-axilla-shoulder

Thorax AND

Abdomen, loins, and buttocks

  • Front: Middle between navel and costal arch

  • Back: Lower border of thoracic vertebrae (midtransverse axis)

Abdomen, loins, and buttock AND

Leg

Groin-trochanter-gluteal sulcus

Right AND

Left

Midline

 

Iliac, other pelvic, abdominal or intrathoracic lymph  nodes are distant.  Code the removal of these nodes under the data item, Surgery of Other Regional Site(s), Distant Site(s), or Distant Node(s).

 

Code

Description

0

No regional lymph nodes removed

1

Sentinel node, NOS

Note: A sentinel node is the first node to receive drainage from a primary tumor. It is identified by an injection of a dye or radio label at the site of the primary tumor.

2

Regional lymph nodes removed, NOS

9

Unknown; not stated; death certificate only

 

NUMBER OF REGIONAL LYMPH NODES EXAMINED

 

Code

Description

00

No regional lymph nodes removed

01

One regional lymph node removed

02

Two regional lymph nodes removed

..

 

90

Ninety or more regional lymph nodes removed

95

No regional lymph nodes removed but aspiration of regional lymph nodes was performed

96

Regional lymph node removal documented as a sampling and number of lymph nodes unknown/not stated

97

Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated

98

Regional lymph nodes surgically removed but number of lymph nodes unknown/not stated and not documented as sampling or dissection

99

Unknown; not stated; death certificate only

 

SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S) OR DISTANT LYMPH NODE(S)

 

Code

Description

0

None; no surgery to other regional or distant sites

1

Surgery to other sites or nodes, NOS; unknown if regional or distant

2

  

Other regional sites

3

  

Distant lymph nodes

4

  

Distant sites

5

  

Combination of 4 with 2 or 3

9

Unknown; not stated; death certificate only

 

RECONSTRUCTION/RESTORATION - FIRST COURSE

 

Code

Description

0

No reconstruction/restoration

1

Pedicle flap, free flap, skin graft, NOS

8

Reconstruction/restoration recommended, unknown if performed

9

Unknown; not stated; death certificate only

 

 

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