GumLower - CS Extension

Note 1: Superficial erosion alone of bone/tooth socket by gingival primary is not sufficient to code as bone involvement (code 700).
Note 2: Periosteum is a fibrous membrane that wraps the outer surface of bones. Mucoperiosteum is a compound structure of mucous membrane and periosteum. Cortical bone is the dense compact outer layer of bone. Trabecular, cancellous, or spongy bone (spongiosa) is a porous network of tissue filling the interior of bone, decreasing weight and allowing room for blood vessels and marrow.
Note 3: AJCC assigns the T category based on size for involvement of cortical bone. Involvement through cortical bone is required for assignment of T4a.
Note 4: The assignment of T1, T2 , and T3 categories for tumors of the lip and oral cavity is based on tumor size. A physician's statement of the T category may be used to code CS Tumor Size and/or CS Extension if this is the only information in the medical record regarding one or both of these fields. However the two fields are coded independently: for example the record may document size but not extension, other than the physician's statement of the T category. Use codes 405, 410, 415, 775, 810, or 815 as appropriate to code CS Extension based on a statement of T when no other extension information is available.
Note 5: Use code 300 for localized tumor only if no information is available to assign codes 100, 405, 410, or 415.

^ For CS Extension codes 100-650 ONLY, the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size Table for this schema.
* For CS Extension codes 100-650 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size, as shown in the Extension Size Table for this schema.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepithelial, noninvasive	Tis	Tis	IS	IS
100	Invasive tumor confined to lamina propria (mucoperiosteum) (stroma)	^	*	L	L
300	Localized, NOS	^	*	L	L
405	Stated as T1 with no other information on extension	^	*	L	L
410	Stated as T2 with no other information on extension	^	*	L	L
415	Stated as T3 with no other information on extension	^	*	L	L
500	OBSOLETE DATA REVIEWED AND CHANGED V0203 Code 500 defined as "Buccal mucosa (inner cheek), Floor of mouth, Labial mucosa (inner lip), lip, Tongue" in CSv1. Code 500 defined as "Buccal mucosa (inner cheek), Floor of mouth, Labial mucosa (inner lip), lower lip, Labial mucosa (inner lip), lower lip, Labial mucosa (inner lip), lip, NOS, Tongue mucosa" in CSv2:V0201, V0202. All cases should be reviewed and recoded to 510, 780, or 785 as appropriate. Buccal mucosa (inner cheek) Floor of mouth Labial mucosa (inner lip), lower lip Labial mucosa (inner lip), lip, NOS Tongue mucosa	ERROR	ERROR	ERROR	ERROR
510	Buccal mucosa (inner cheek) Floor of mouth Labial mucosa (inner lip), lower lip Labial mucosa (inner lip), lip, NOS Tongue mucosa	^	*	RE	RE
535	Cortical bone of mandible Mandible, NOS Cortical bone, NOS Cartilage, NOS Bone, NOS	^	*	RE	RE
550	Facial muscle, NOS Subcutaneous soft tissue of face	^	*	RE	RE
600	Lateral pharyngeal wall Tonsillar pillars and fossae Tonsils	^	*	RE	RE
650	Soft palate including uvula	^	*	RE	RE
700	OBSOLETE DATA REVIEWED AND CHANGED V0203 Code 700 defined as "Mandible" in CSv1. All CSv1 cases should be reviewed and recoded to 535 or 725 as appropriate. Mandible	ERROR	ERROR	ERROR	ERROR
720	Deep (extrinsic) muscle of tongue: Genioglossus Hyoglossus Palatoglossus Styloglossus	T4a	T4a	RE	RE
725	Trabecular bone of mandible	T4a	T4a	RE	RE
760	Skin of face	T4a	T4a	D	D
770	Bone of maxilla Maxilla, NOS	T4a	T4a	D	D
775	Stated as T4a with no other information on extension	T4a	T4a	RE	RE
780	Labial mucosa (inner lip), upper lip	T4b	T4b	D	RE
785	780 + (760 or 770) Mucosa upper lip plus any structure in code 760 or 770	T4b	T4b	D	D
788	Specified bone (Other than mandible, maxilla, and bones in codes 795 and 805)	T4b	T4b	D	D
790	OBSOLETE DATA CONVERTED V0200 See code 805 Skull	ERROR	ERROR	ERROR	ERROR
795	Masticator space Pterygoid plates	T4b	T4b	D	D
800	OBSOLETE DATA RETAINED V0200 Further contiguous extension, including: Masticator space Pterygoid plates Skull base Encases internal carotid artery	ERROR	T4b	D	D
805	Further contiguous extension, including: Base of skull Internal carotid artery (encased) Skull	T4b	T4b	D	D
810	Stated as T4b with no other information on extension	T4b	T4b	D	D
815	Stated as T4 [NOS] with no other information on extension	T4NOS	T4NOS	D	D
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