1. 1 Head and Neck

2. 2 Equivalent Terms, Definitions, Charts, Tables and Illustrations Primary site –Do not code biopsy site

3. 3 Priority Order Code Primary Site 1.Tumor Board a. Specialty b. General

4. 4 Priority Order Code Primary Site 2.Staging physician’s site assignment a. AJCC staging form b. TNM statement in medical record If neither 1 or 2 available, based on whether tumor was resected

5. 5 Priority Order Code Primary Site 3.Total resection of primary tumor (margins may be microscopically positive) a. Operative report – surgeon’s statement b. Final diagnosis on pathology report

6. 6 Priority Order Code Primary Site 4.No resection (may have biopsy) a. Endoscopy b. Radiation oncologist c. Diagnosing physician d. Primary care physician Continued on next slide

7. 7 Priority Order Code Primary Site e. Other physician f. Diagnostic imaging g. Physician statement based on clinical examination

8. 8 Default Site Codes Point of origin cannot be determined –C02.8 Overlapping lesion of tongue –C08.8 Overlapping lesion of major salivary glands –C14.8 Overlapping lesion of lip, oral cavity, and pharynx.

9. 9 Column 1: Paired Sites Column 2: Code Parotid GlandsC079 Major Salivary GlandsC080; C081 TonsilsC090; C091; C098; C099 Nasal CavityC300 Accessory SinusesC310; C312 Middle EarC301 Table 1 – Paired Sites

10. 10 Chart 1 – H&N Histology Groups and Specific Types Use this chart with the histology rules to code the most specific histologic term. The tree is arranged in descending order. Each branch is a histology group, starting with the NOS or group terms and descending into the specific types for that group. As you follow the branch down, the terms become more specific

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12. 12 Multiple Primary Rules

13. 13 Unknown if Single or Multiple Tumors

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15. 15 Single Tumor

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17. 17 Multiple Tumors

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28. 28 Histology Rules

29. 29 Single Tumor

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35. 35 Multiple Tumors Abstracted as a Single Primary

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41. 41 MP/H Task Force