MP/H Rules Presentation - Melanoma of Skin · Code 8742 (Lentigo maligna melanoma) when the...
Transcript of MP/H Rules Presentation - Melanoma of Skin · Code 8742 (Lentigo maligna melanoma) when the...
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Cutaneous Melanoma
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Equivalent Terms, Definitions and Illustrations
• Skin only C440-C449• Definitions identify reportable tumors
– Evolving melanoma – not reportable
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Equivalent Terms, Definitions and Illustrations
• Familial Atypical Multiple Mole Melanoma Syndrome (FAMM or FAM-M)– Melanoma in family members– Family with multiple moles
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Regressing Melanoma• Not a histology
– Has ICD-O-3 code• Prognostically significant
– Thinner– Staging difficult
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Equivalent Terms, Definitions and Illustrations
• Skin layers– Epidermis– Dermis– Hypodermis/subcutis/subcutaneous fat
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Multiple Primary Rules
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Unknown if Single or Multiple Melanomas
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M1
When it is not possible to determine if there is a single melanoma or multiplemelanomas, opt for a single melanoma and abstract as a single primary.
Note: Use this rule only after all information sources have been exhausted.
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Single Melanoma
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M2
A single melanoma is always a single primary.
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Multiple Melanomas
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M3
Melanomas in sites with ICD-O-3 topography codes that are different at the second (Cxxx), third (Cxxx) or fourth (C44x) character are multiple primaries.
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M4
Melanomas with different laterality are multiple primaries.
Note: A midline melanoma is a different laterality than right or left.
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M4 Examples
Example 1: Melanoma of the right side of the chest and a melanoma at midline of the chest are different laterality, multiple primaries.
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M4 Examples
Example 2: A melanoma of the right side of the chest and a melanoma of the left side of the chest are multiple primaries.
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M5
Melanomas with ICD-O-3 histology codes that are different at the first (xxxx), second (xxxx) or third number (xxxx) are multiple primaries.
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M6
An invasive melanoma that occurs more than 60 days after an in situ melanoma is a multiple primary.
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M6 Notes
Note 1: The purpose of this rule is to ensure that the case is counted as an incident (invasive) case when incidence data are analyzed.
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M6 Notes
Note 2: Abstract as multiple primaries even if the medical record/physician states it is recurrence or progression of disease.
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M7
Melanomas diagnosed more than 60 daysapart are multiple primaries.
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M8
Melanomas that do not meet any of the above criteria are abstracted as a single primary.
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M8 Notes
Note 1: Use the data item “Multiplicity Counter” to record the number of melanomas abstracted as a single primary.
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M8 Notes
Note 2: When an invasive melanoma follows an in situ melanoma within 60 days, abstract as a single primary.
Note 3: All cases covered by this rule are the same site and histology.
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M8 Examples
This is NOT intended to be an exhaustive set of examples; there are other cases that may be classified as a single primary. Warning: Using only these case examples to determine the number of primaries can result in major errors.
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M8 Examples
Example 2: Solitary melanoma on the right thigh and another solitary melanoma on the right ankle
Example 1: Solitary melanoma on the left back and another solitary melanoma on the left chest
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Histology Coding Rules
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Single Melanoma or Multiple Melanomas Abstracted as a
Single Primary
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H1
Code the histology documented by the physician when there is no pathology/cytology specimen or the pathology/cytology report is not available.
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H1 Notes
Note 1: Priority for using documents to code the histology•Documentation in the medical record that refers to pathologic or cytologic findings•Physician’s reference to type of melanoma in the medical record•PET scan
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H1 Notes
Note 2: Code the specific histology when documented.
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H2
Code the histology from the metastatic site when there is no pathology/cytology specimen from the primary site.
Note: Code the behavior /3
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H3
Code the histology when only one histologic type is identified.
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H4
Code the invasive histologic type when there are invasive and in situ components.
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H5
Code the histologic type when the diagnosis is regressing melanoma and a histologictype.
Example: Nodular melanoma with features of regression. Code 8721 (Nodular melanoma).
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H6
Code 8723 (Malignant melanoma, regressing) when the diagnosis is regressing melanoma.
Example: Malignant melanoma with features of regression. Code 8723.
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H7
Code the histologic type when the diagnosis is lentigo maligna melanoma and a histologic type.
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H8
Code 8742 (Lentigo maligna melanoma) when the diagnosis is lentigo malignamelanoma
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H9
Code the most specific histologic termwhen the diagnosis is melanoma, NOS (8720) with a single specifc type.
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H9 Notes
Note 1: The specific type for in situ lesions may be identified as pattern, architecture, type, subtype, predominantly, with features of, major, or with ____differentiation
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H9 Notes
Note 2: The specific type for invasive lesions may be identified as type, subtype, predominantly, with features of, major, or with ____differentiation
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H10
Code the histology with the numerically higher ICD-O-3 code.
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MP/H Task Force