MelanomaSkin - CS Lymph Nodes

Note 1: Code only regional nodes and nodes, NOS in this field. Distant nodes are coded in CS Mets at DX.
Note 2: According to AJCC, p. 325, "There is no lower threshold of tumor burden defining the presence of regional nodal metastasis. Specifically, nodal tumor deposits less than 0.2 millimeter (mm) in diameter (previously used as the threshold for defining nodal metastasis), are included in the staging of nodal disease as a result of the consensus that smaller volumes of metastatic tumor are still clinically significant". This means that any finding of melanoma in lymph nodes, regardless of size and including isolated tumor cells (ITCs), should be coded as positive lymph nodes in this field. If only ITCs are present, use code 010.
Note 3: Bilateral or contralateral nodes are considered regional nodes for head, neck, and truncal tumors with bidirectional drainage to primary nodal basins, as shown on lymphoscintigraphy. Truncal tumors may also drain to both cephalad and caudal primary nodal basins as shown on lymphoscintigraphy. Clinical assessment of bilateral/contralateral or cephalad/caudal regional nodal involvement is required for tumors where lymphoscintigraphy is not performed.
Note 4: Contiguous or secondary nodal basins are the next nodal drainage basins beyond the primary nodal basins. Secondary basins are considered regional for AJCC staging but may be distant for Summary Stage. Use code 115 for involvement of nodes in secondary nodal basins not specified in codes 100 and 110.
Note 5: Satellite lesions/nodules or in-transit metastases are coded in this field. Use codes 100-118 if there is regional node involvement without satellite nodules or in-transit metastases. Use codes 140-151 if there are satellite nodules or in-transit metastases but there is either no regional lymph node involvement, or involvement of regional nodes is not stated. Use codes 200-223 if both satellite nodules/in-transit metastases and regional lymph nodes are present.
Note 6: If the only information about lymph nodes is a statement of N1 involvement without a clinical or pathologic designation, use code 125.
If the only information about lymph nodes is a statement of N2 involvement without a clinical or pathologic designation, use code 155.

^ When evaluation is clinical (CS Lymph Nodes Eval = 0, 1, 5, 9) for CS Lymph Nodes codes 010-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 7 staging depends on the values in CS Site-Specific Factor 3, as shown in the Lymph Nodes and Nodal Status Clinical Eval AJCC 7 Table. When evaluation is pathologic (CS Lymph Nodes Eval = 2, 3, 6, 8), for CS Lymph Nodes codes 010-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 7 staging depends on the values in CS Site-Specific Factor 3 and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Pathologic Eval AJCC 7 Table. When evaluation is not coded (CS Lymph Nodes Eval = blank), for CS Lymph Nodes codes 010-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 7 staging depends on the values in CS Site-Specific Factor 3 and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Pathologic Eval Blank AJCC 7 Table.
* When evaluation is clinical (CS Lymph Nodes Eval = 0, 1, 5, 9) for CS Lymph Nodes codes 100-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 6 staging depends on the values in CS Site-Specific Factor 3, as shown in the Lymph Nodes and Nodal Status Clinical Eval AJCC 6 Table. When evaluation is pathologic (CS Lymph Nodes Eval = 2, 3, 6, 8), for CS Lymph Nodes codes 100-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 6 staging depends on the values in CS Site-Specific Factor 3 and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Pathologic Eval AJCC 6 Table. When evaluation is not coded (CS Lymph Nodes Eval = blank), for CS Lymph Nodes codes 100-118, 121-128, 152, 153, and 155-158 ONLY, the N category for AJCC 6 staging depends on the values in CS Site-Specific Factor 3 and Regional Nodes Positive, as shown in the Lymph Nodes and Nodal Status Eval Blank AJCC 6 Table.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	No regional lymph node involvement	N0	N0	NONE	NONE
010	Isolated tumor cells (ITCs) only	^	N0	NONE	NONE
100	Regional lymph nodes by primary site (includes bilateral or contralateral nodes for head, neck, and trunk): HEAD AND NECK SITES: All subsites: Cervical, NOS Lip: Facial, NOS: Mandibular Submandibular(submaxillary) Eyelid/canthus: Facial, NOS: Buccinator (buccal) Nasolabial Mandibular Submandibular (submaxillary) Parotid, NOS: Infraauricular External ear/auditory canal: Mastoid (post-/retroauricular ) (occipital) Preauricular Face, Other (cheek, chin forehead, jaw, nose and temple): Facial, NOS: Buccinator (buccal) Nasolabial Mandibular Submandibular (submaxillary) Parotid, NOS: Infraauricular Preauricular Scalp: Mastoid (post-/retroauricular) (occipital) Parotid, NOS: Infraauricular Preauricular Spinal accessory (posterior cervical) Neck: Axillary Mandibular Mastoid (post-/retroauricular ) Parotid, NOS: Infraauricular Preauricular Spinal accessory (posterior cervical) Supraclavicular (transverse cervical) UPPER TRUNK: Axillary Cervical Internal mammary Supraclavicular LOWER TRUNK: Superficial inguinal (femoral) ARM/SHOULDER: Axillary Epitrochlear for hand/forearm Spinal accessory (posterior cervical) for shoulder LEG/HIP: Popliteal for heel and calf Superficial inguinal (femoral) VULVA/PENIS/SCROTUM: Deep inguinal: Rosenmuller or Cloquet node Superficial inguinal (femoral) ALL SITES: Regional lymph node(s), NOS (See Note 3)	^	*	RN	RN
110	Regional lymph node(s) by primary site (includes bilateral or contralateral nodes for head and neck): HEAD AND NECK SITES: Lip: Facial, NOS: Buccinator (buccal) Nasolabial Submental Parotid, NOS Infraauricular Preauricular Eyelid/canthus: Submental Face, Other (cheek, chin, forehead, jaw, nose, and temple): Submental Neck: Submental (See Note 3)	^	*	D	RN
115	Head (includes bilateral or contralateral nodes for head and trunk): All subsites: Supraclavicular Upper Trunk: Femoral (or cephalad/caudal drainage from primary tumor) (see Note 2) Lower Trunk: Axillary (or cephalad/caudal drainage from primary tumor) (see Note 2) Arm/Shoulder: Supraclavicular Leg/Hip: Iliac All sites: Regional lymph node(s) in two contiguous secondary nodal basins (to secondary nodal basin) (See Notes 2, 3)	^	*	D	D
118	115 + (100 and/or 110) Regional lymph nodes coded in 115 plus regional lymph nodes coded in 100 and/or 110	^	*	D	D
120	OBSOLETE DATA CONVERTED V0204 See code 110 Regional lymph node(s) by primary site: HEAD AND NECK SITES: Lip: Facial, NOS: Buccinator (buccal) Nasolabial Submental Parotid, NOS Infraauricular Preauricular Eyelid/canthus: Submental Face, Other (cheek, chin, forehead, jaw, nose, and temple): Submental Neck: Submental (See Note 3)	ERROR	ERROR	ERROR	ERROR
121	Evaluated clinically: Clinically stated as N1 with no other information on regional lymph nodes	^	*	RN	RN
122	Evaluated pathologically: Pathologically stated as N1a with no other information on regional lymph nodes	^	*	RN	RN
123	Evaluated pathologically: Pathologically stated as N1b with no other information on regional lymph nodes	^	*	RN	RN
124	Evaluated pathologically: Pathologically stated as N1 [NOS] with no other information on regional lymph nodes	^	*	RN	RN
125	Stated as N1 [NOS] with no information on clinical or pathologic evaluation	^	*	RN	RN
128	Evaluated clinically: Clinically stated as N2 with no other information on regional lymph nodes	^	*	RNOS	RNOS
130	OBSOLETE DATA CONVERTED V0204 See code 151 Satellite nodule(s) or in-transit metastases, NOS (Distance from primary tumor not stated) WITHOUT regional lymph node involvement or involvement of regional nodes not stated	ERROR	ERROR	ERROR	ERROR
140	Satellite nodule(s) or in-transit metastases less than or equal to 2cm from primary tumor WITHOUT regional lymph node involvement or involvement of regional nodes not stated	N2c	N2c	L	RE
150	Satellite nodule(s) or in-transit metastases greater than 2cm from primary tumor WITHOUT regional lymph node involvement or involvement of regional nodes not stated.	N2c	N2c	RE	RN
151	Satellite nodule(s) or in-transit metastases, NOS (Distance from primary tumor not stated) WITHOUT regional lymph node involvement or involvement of regional nodes not stated	N2c	N2c	RE	RNOS
152	Evaluated pathologically: Pathologically stated as N2a with no other information on regional lymph nodes	^	*	RN	RN
153	Evaluated pathologically: Pathologically stated as N2b with no other information on regional lymph nodes	^	*	RN	RN
154	Stated as N2c with no other information on satellite nodules	N2c	N2c	RE	RE
155	Stated as N2 [NOS] with no information on pathologic or clinical evaluation	^	*	RNOS	RNOS
158	Evaluated pathologically: Pathologically stated as N2 [NOS] with no other information on regional lymph nodes	^	*	RNOS	RNOS
170	Matted lymph nodes in code 100	N3	N3	RN	RN
180	Matted lymph nodes in code 110	N3	N3	D	RN
190	Matted lymph nodes in code 115	N3	N3	D	D
195	190 + (170 and/or 180) Matted lymph nodes in code 190 plus matted lymph nodes in code 170 and/or code 180	N3	N3	D	D
200	Satellite nodule(s) or in-transit metastases WITH regional lymph nodes listed in code 100.	N3	N3	RE+RN	RNOS
220	Satellite nodule(s) or in-transit metastases WITH regional lymph nodes listed in code 110	N3	N3	D	RNOS
223	Satellite nodule(s) or in-transit metastases WITH regional lymph nodes listed in code 115	N3	N3	D	D
225	Stated as N3 with no other information on regional lymph nodes	N3	N3	RNOS	RNOS
800	Lymph nodes, NOS	N1NOS	N1NOS	RN	RN
999	Unknown; regional lymph nodes not stated Regional lymph nodes cannot be assessed Not documented in patient record	NX	NX	U	U