V.4.2.6 Mets at Diagnosis – Other

Coding Instructions:

• Code information about other metastasis only (discontinuous or distant) to other sites identified at the time of diagnosis.

NOTE: Do not code this field for bone, brain, liver, lung, or distant lymph node metastasis.

• Metastatic involvement may be single (one focus of metastatic disease) or multiple (multiple foci of metastatic disease in the same site or multiple sites).

• Information regarding other involvement may be clinical or pathologic.

• Code this field for other metastasis even if the patient had neoadjuvant (preoperative) systemic therapy, unless it is determined to be disease progression.

• Code other involvement in this field for all solid tumors, Kaposi’s sarcoma, Lymphomas, Unknown primary site and Other and Ill-defined primary sites.  

• Code this field for Lymphomas of all sites for the histologies (9590-9699, 9702-9727, 9735, 9737-9738, 9811-9818, 9823, 8927, and 9737).

• Assign the code that best describes whether the case has other metastasis at diagnosis.

• Use code 0 when the medical record:

• Indicates no other sites of distant (discontinuous) metastases. Including:

• A negative clinical or pathologic statement

• Negative imaging reports

• Mentions (discontinuous) metastasis but other sites are not stated as involved.

• Use code 1 when the medical record confirms:

• The patient has distant (discontinuous) metastasis sites other than bone, brain, liver, lung, or distant lymph nodes are mentioned as involved.

Examples: Include but are not limited to – adrenal gland, bone marrow, pleura, malignant pleural effusion, peritoneum, and skin.

• Lymphomas with bone marrow involvement (Stage IV disease)

NOTE: Lymphomas or lymphoma/leukemias where primary site is C421 are NOT coded in this field.

• Use code 2 when the medical record:

• Indicates patient has carcinomatosis (a condition in which the cancer has spread widely throughout the body, or to a relatively large region of the body)

NOTE: It is possible to have metastatic disease to a specific organ AND also have carcinomatosis. Be sure to code the specific site as well as the carcinomatosis.

• Use code 8 (Not applicable) for the following site/histology combinations for which a code for distant metastasis is not clinically relevant:

• Use code 9 when the patient is known to have distant metastasis but it cannot be determined whether the distant metastasis include other than bone, brain, liver, lung and distant lymph node(s).

Codes:

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