BileDuctsPerihilar - CS Extension

Note 1: Perihilar bile duct tumors arise at the confluence of the right and left hepatic ducts in the hilar area of the liver.
Note 2: The biliary radicals are the ducts or tubes that drain bile into the intestine as part of the digestive process. The second-order biliary radicals are the next largest branches or ducts of the biliary system which join to form or empty into the main hepatic bile duct.
Note 3: For AJCC 7 staging, T3 and T4 are defined strictly in terms of invasion into specific large blood vessels and the biliary radicals within the liver. Give priority to coding invasion into blood vessels and biliary radicals over the named structures in . codes 605, 651, 700, 760, and 800. Use combination codes 665, 720, and 815 when information is available regarding extension to the specified vessels and/or the biliary radicals within the liver plus involvement of other named organs.
Note 4: Involvement within the porta hepatis is coded according to the structures involved: portal vein, common hepatic artery, and common hepatic duct.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepithelial, noninvasive	Tis	Tis	IS	IS
100	Invasive tumor of perihilar (proximal) bile duct(s) confined to: Lamina propria Mucosa, NOS Submucosa (superficial invasion)	T1	T1	L	L
200	Muscularis propria	T1	T1	L	L
300	Localized, NOS	T1	T1	L	L
350	Stated as T1 with no other information on extension	T1	T1	L	L
400	Beyond wall of bile duct Periductal/fibromuscular connective tissue	T2a	T2	RE	RE
450	Stated as T2a with no other information on extension	T2a	T2	RE	RE
500	Adjacent hepatic parenchyma	T2b	T3	RE	RE
510	Liver extension, NOS Liver, NOS	T2b	T3	RE	RE
550	Stated as T2b with no other information on extension	T2b	T2	RE	RE
555	Stated as T2 [NOS] with no other information on extension	T2NOS	T2	RE	RE
560	OBSOLETE DATA REVIEWED V0203 See codes 100, 510, 661, and 665 Liver, porta hepatis	T2b	T3	RE	RE
600	OBSOLETE DATA RETAINED V0200 See codes 560 and 605 Gallbladder Liver, porta hepatis Pancreas	ERROR	T3	RE	RE
605	Gallbladder Pancreas	TX	T3	RE	RE
610	Unilateral branches of portal vein (right or left) Unilateral branches of hepatic artery (right or left)	T3	T3	RE	RE
612	610 + 605	T3	T3	RE	RE
615	Stated as T3 with no other information on extension	T3	T3	RE	RE
650	OBSOLETE DATA RETAINED V0200 See code 651 Colon, NOS Transverse including flexure Duodenum, NOS Omentum, NOS Lesser Stomach, distal	ERROR	T4	RE	RE
651	Colon, NOS: Transverse including flexures Duodenum, NOS Omentum, NOS: Lesser Stomach, distal	TX	T4	RE	RE
660	OBSOLETE DATA RETAINED V0200 See code 661 Main portal vein or its branches bilaterally Common hepatic artery Hepatic artery, NOS Portal vein, NOS	ERROR	T4	RE	RE
661	Main portal vein or its branches bilaterally Common hepatic artery Hepatic artery, NOS Portal vein, NOS	T4	T4	RE	RE
665	661 + (605 and/or 651)	T4	T4	RE	RE
670	Tumor invades second-order biliary radicals bilaterally OR Tumor invades unilateral second-order biliary radicals with contralateral portal vein or hepatic artery involvement	T4	T4	RE	RE
700	Other parts of colon Greater omentum Stomach, proximal	TX	T4	D	RE
720	700 + (661, 665, or 670)	TX	T4	D	RE
750	OBSOLETE DATA RETAINED V0200 See code 760 Abdominal wall	ERROR	T4	D	D
760	Abdominal wall	TX	T4	D	D
800	Further contiguous extension	TX	T4	D	D
810	800 + (700 or 760)	TX	T4	D	D
815	(760, 800, or 810) + (661 or 670) Involvement of structures in 760, 800, or 810 plus involvement of blood vessels as described in 661 or blood vessels and biliary radicals as described in 670	T4	T4	D	D
820	Stated as T4 with no other information on extension	T4	T4	RE	RE
950	No evidence of primary tumor	T0	T0	U	U
999	Unknown; extension not stated Primary tumor cannot be assessed Not documented in patient record	TX	TX	U	U