Skin

Note 1: For AJCC 7 staging, the T category is not only dependent on tumor size but also on several high risk features that can upgrade the T assignment.
Note 2: Based on the information in the medical record, the registrar is required to count and code the number of high risk features (each feature equals 1 risk factor). If specific information is available about some but not all of the high risk features, count the number of features documented in the record.
    Poorly differentiated/Undifferentiated (grade 3 or 4)
    Depth greater than 2 millimeter (mm) thickness
    Clark level IV or V
    Perineural invasion
    Primary site: skin of external ear (C44.2) OR skin of lip (hair-bearing, also called non-glabrous lip) (C44.0)
Note 3: Use codes 991, 992, and 993 only if no specific information is available about the high risk features (other than primary site), but the record contains a general statement about the presence of high risk features.
Note 4: The definition of high risk features was changed with the release of CSv2:V0203: Lymph-vascular invasion was removed as a high-risk feature, and tumor depth was changed from greater than or equal to 4 mm to greater than 2 mm. All cases with codes 000-004 coded in or updated to CSv2:V0202 should be reviewed and the correct number of high-risk features determined and coded.

Code	Description
000	No high risk features
001	1 high risk feature
002	2 high risk features
003	3 high risk features
004	4 high risk features
005	5 high risk features
006	OBSOLETE DATA CONVERTED V0203 The list of high risk features in CS Version 2: V0201, V0202 included depth equal to or greater than 4 millimeters (mm) and lymph-vascular invasion. Depth was changed to greater than 2 mm and lymph-vascular invasion removed in the final list of high risk features published by AJCC. Cases coded 006 are converted to 005 in CS Version 2: V0203. 6 high risk features
988	Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 988 may result in an edit error.)
991	Stated as less than 2 high risk features
992	Stated as 2 or more high risk features
993	Stated as high risk features, NOS
999	Unknown or no information Not documented in patient record

CS Site-Specific Factor 12High Risk Features