V.3.4 Behavior

The Behavior Code describes the malignant potential of the tumor.  Codes range from /0-benign to /3-malignant (invasive). The fifth digit of the morphology code is the Behavior Code.

 

Coding Instructions:

  1. Intracranial and CNS tumor with behavior codes /0-benign or /1-borderline are reportable for cases diagnosed 1/1/2001 forward.

  2. Code behavior from CT scan, MRI or PET scans when there is no tissue diagnosis (no pathology or cytology report).  Code the behavior as indicated on the scan.

    1. Do not use WHO grade to code behavior.

  3. Clinical evidence alone is not sufficient to identify behavior as in situ.  A behavior code of /2-in situ must be based on pathologic examination.

Note: If Diagnostic Confirmation is Clinical (8), then behavior cannot be /2-in situ

  1. Behavior codes of /6 or /9 per ICD-0-3 are NOT reportable. An edit error will be received when attempting to enter /6 or /9 for behavior.

  2. Code /3-malignant when malignant metastasis is identified.

    1. Examples shown below are  representative and are not intended to represent all possible scenarios:

      1. GIST tumor where lymph nodes are positive for malignancy, or

      2. Atypical Thymoma with malignant metastasis in one lymph node

  1. Code behavior as /3-malignant if any portion of the primary tumor is invasive, regardless of how limited (i.e., microinvasion).

    1. Example below is representative and not intended to represent all possible scenarios:

      1. Intraductal carcinoma of the breast with focal areas of invasion

  1. The pathologist has the final decision on the behavior of the tumor.  The applicable ICD-0-3 code may indicate /3-malignant behavior, however, the pathologist may indicate the specimen is /2-in situ.  Code the /2 behavior per the pathologist’s findings.  The reverse scenario also applies.

  2. Re-Code the behavior as malignant /3 when metastases are attributed to a tumor originally thought to be insitu.

  3. Do not code in situ behavior with a primary site that is unknown or ill-defined.  A behavior code of /2-in situ combined with any of the following primary sites will result in an error:

    1. C26.9 Gastrointestinal tract, NOS

    2. C39.9 Ill-Defined sites within respiratory system

    3. C55.9 Uterus, NOS

    4. C57.9 Female genital tract, NOS

    5. C639 Male genital organs, NOS

    6. C68.9 Urinary system, NOS

    7. C72.9 Nervous system, NOS

    8. C75.9 Endocrine gland, NOS

    9. C76.__ Other and ill-defined sites

    10. C80.9 Unknown primary site

 
Codes:

Code

Description

/0*

Benign

/1*

Uncertain whether benign or malignant

 

Borderline Malignancy (except cystadenomas in the range 844-849)

 

Low Malignant Potential

/2

Carcinoma in Situ (see section In Situ Coding for synonyms)

/3

Malignant, Primary Site (includes microinvasion)

/6

Malignant, Metastatic Site, Malignant, secondary site -- Reportable behavior but enter code 3

(Code 6 NOT Used by Cancer Registries)

 

Malignant, Secondary Site

/9**

Malignant, uncertain whether primary or metastatic site

Benign and borderline Brain and CNS tumors are reportable to CCR for cases diagnosed 1/1/2001 forward.

 

 

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