Shotty lymph nodes size4/6/2024 If there is evidence of nodal involvement associated with a tumor described as in situ, it would indicate that an area of invasion was simply missed, and it is NOT an in situ lesion. Use code 00 for lymph node involvement when the CS Extension is coded in situ, even if no lymph nodes are removed, since "in situ" by definition means noninvasive.If the patient receives preoperative (neoadjuvant) systemic therapy (chemotherapy, hormone therapy, immunotherapy) or radiation therapy, code the farthest involved regional lymph nodes, whether this is based on information prior to surgery or following treatment.If there is direct extension of the primary tumor into a regional lymph node, record the involved node in this field.After axillary dissection, all lymph nodes are negative.Ĭode CS Lymph Nodes as 0, no regional lymph node involvement. If there is a discrepancy between clinical information and pathologic information about the same lymph nodes, the pathologic information takes precedence.Įxample: Axillary lymphadenopathy stated as "suspicious for involvement" noted on physical exam.Record involved regional lymph nodes from the pathology report, if it is available, when the patient receives no radiation or systemic treatment prior to surgery.Use the code for contralateral mediastinal lymph node involvement as it is higher than the code for peribronchial lymph nodes. Patient chooses radiation therapy as primary treatment. Contralateral mediastinal mass noted on CT scan but not biopsied. Record the highest applicable code.Įxample: Peribronchial lymph nodes are positive on fine needle aspiration biopsy. In addition, for some sites, regional lymph nodes are further classified by size, laterality, and number of involved nodes. The regional lymph nodes closest to the primary site have lower codes than nodes farther away. Regional lymph nodes are listed for each site.Record the farthest specific regional lymph node chain that is involved by tumor either clinically or pathologically.Acknowledgements General Rules Coding CS Lymph Nodes
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