MerkelCellVulva - CS Extension

Note 1: In the case of multiple simultaneous tumors, code the tumor with the greatest extension.
Note 2: Skin ulceration does not alter the AJCC T category.
Note 3: In-transit metastasis is coded in CS Lymph Nodes.
Note 4: The depth of stromal invasion is defined as the measurement of the tumor from the epithelial-stromal junction of the adjacent most superficial dermal papilla to the deepest point of invasion.
Note 5: Use codes 110-130 and 410-430 for tumors limited to the skin or subcutaneous/submucosal tissues of vulva and perineum only. Use code 602 for tumors involving fascia or musculature of vulva and perineum.
Note 6: The assignment of the T1, T2, and T3 categories for Merkel cell carcinomas is based on tumor size. A physician's statement of the T category may be used to code both 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. Use codes 450, 460, 470, and 810 as appropriate to code CS Extension based on a statement of T when no other extension information is available.

^ For CS Extension codes 105-470 ONLY the T category for AJCC 7 staging is assigned based on the value of CS Tumor Size and CS Extension as shown in the Extension Size AJCC 7 Table for this schema.
* For CS Extension codes 100-510 ONLY, the T category for AJCC 6 staging is assigned based on the value of CS Tumor Size and CS Extension, as shown in the Extension Size AJCC 6 Table for this schema.

Code	Description	TNM 7 Map	TNM 6 Map	SS77 Map	SS2000 Map
000	In situ, intraepidermal, intraepithelial, noninvasive	Tis	Tis	IS	IS
100	OBSOLETE DATA RETAINED AND REVIEWED V0203 See codes 150, 200, 500 Invasive cancer (no stromal invasion) confined to: Musculature Submucosa Vulva including skin	TX	*	L	L
105	OBSOLETE DATA CONVERTED V0203 See code 130 Vulva only: Stromal invasion but level of invasion in mm not stated	ERROR	ERROR	ERROR	ERROR
110	Vulva only: Stromal invasion less than or equal to 1 mm	^	*	L	L
120	Vulva only: Stromal invasion greater than 1 mm	^	*	L	L
130	Vulva only: Stromal invasion but level of invasion in mm not stated	^	*	L	L
150	Submucosa	^	*	L	L
200	Confined to vulva, NOS	^	*	L	L
300	Localized, NOS	^	*	L	L
400	OBSOLETE DATA CONVERTED V0203 See code 430 Vulva and perineum, level of invasion in mm not stated	ERROR	ERROR	ERROR	ERROR
410	Vulva and perineum, stromal invasion less than or equal to 1 mm	^	*	RE	RE
420	Vulva and perineum, stromal invasion greater than 1 mm	^	*	RE	RE
430	Vulva and perineum, level of invasion in mm not stated	^	*	RE	RE
450	Stated as T1 with no other information on extension	^	*	L	L
460	Stated as T2 with no other information on extension	^	*	L	L
470	Stated as T3 with no other information on extension	^	*	L	L
500	Fascia Musculature, skeletal muscle	T4	*	L	L
510	500 + (410, 420, 430)	T4	*	RE	RE
600	OBSOLETE DATA RETAINED V0200 Anus Perianal skin Urethra (See code 750 for upper urethral mucosa) Vagina	ERROR	T3	RE	RE
605	Anus Perianal skin Urethra (lower/distal 1/3 urethra or not stated) (See code 750 for upper urethra)	T4	T3	RE	RE
610	Vagina (lower/distal 1/3 vagina)	T4	T3	RE	RE
612	Vagina NOS	T4	T3	RE	RE
618	Vagina (upper/proximal 2/3 vagina)	T4	T3	RE	RE
620	Bladder wall or bladder, NOS excluding mucosa Rectal wall or rectum, NOS excluding mucosa	T4	T3	D	RE
700	Perineal body Rectal mucosa	T4	T4	D	D
750	OBSOLETE DATA RETAINED V0200 Bladder mucosa Fixed to pubic bone Upper urethral mucosa	ERROR	T4	D	D
760	Bladder mucosa Urethra (upper/proximal 2/3 urethra)	T4	T4	D	D
765	Extension to underlying cartilage, bone Fixed to pubic bone	T4	T4	D	D
770	OBSOLETE DATA REVIEWED AND CHANGED V0203 See codes 500, 510, 765, 775, 778 Fixed to pubic bone Underlying cartilage, bone, skeletal muscle	ERROR	ERROR	ERROR	ERROR
775	(605-700, 760) + 500	T4	T4	D	D
778	765 + 500	T4	T4	D	D
800	Further contiguous extension	T4	T4	D	D
810	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