MP H Task Force Multiple Primary Rules Histology Coding

MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Head and Neck 1

Equivalent Terms, Definitions, Charts, Tables and Illustrations • Primary site – Do not code biopsy site 2

Priority Order Code Primary Site 1. Tumor Board a. Specialty b. General 3

Priority Order Code Primary Site 2. Staging physician’s site assignment a. AJCC staging form b. TNM statement in medical record If neither 1 or 2 available, based on whether tumor was resected 4

Priority Order Code Primary Site 3. Total resection of primary tumor (margins may be microscopically positive) a. Operative report – surgeon’s statement b. Final diagnosis on pathology report 5

Priority Order Code Primary Site 4. No resection (may have biopsy) a. Endoscopy b. Radiation oncologist c. Diagnosing physician d. Primary care physician Continued on next slide 6

Priority Order Code Primary Site e. Other physician f. Diagnostic imaging g. Physician statement based on clinical examination 7

Default Site Codes • Point of origin cannot be determined – C 02. 8 Overlapping lesion of tongue – C 08. 8 Overlapping lesion of major salivary glands – C 14. 8 Overlapping lesion of lip, oral cavity, and pharynx. 8

Table 1 – Paired Sites Column 1: Paired Sites Parotid Glands Major Salivary Glands Tonsils Nasal Cavity Accessory Sinuses Middle Ear Column 2: Code C 079 C 080; C 081 C 090; C 091; C 098; C 099 C 300 C 310; C 312 C 301 9

Chart 1 – H&N Histology Groups and Specific Types Use this chart with the histology rules to code the most specific histologic term. The tree is arranged in descending order. Each branch is a histology group, starting with the NOS or group terms and descending into the specific types for that group. As you follow the branch down, the terms become more specific 10

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MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Multiple Primary Rules 12

MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Unknown if Single or Multiple Tumors 13

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MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Single Tumor 15

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MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Multiple Tumors 17

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MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Histology Rules 28

MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Single Tumor 29

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MP/H Task Force Multiple Primary Rules Histology Coding Rules 2007 Multiple Tumors Abstracted as a Single Primary 35

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MP/H Task Force 41