melanoma by abhishek jaguessar

8/4/2019 Melanoma by Abhishek Jaguessar

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Melanoma

ByABHISHEK JAGUESSAR


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Cutaneous Melanoma


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Equivalent Terms, Definitions

and Illustrations Skin only C440-C449

Definitionsidentify reportable tumors

Evolving melanoma not reportable


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and Illustrations Familial Atypical Multiple Mole Melanoma

Syndrome (FAMM orFAM-M)

Melanoma in family members

Family with multiple moles


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Regressing Melanoma

Not a histology

Has ICD-O-3code

Prognostically significant Thinner

Staging difficult


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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 MultipleMelanomas


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M1

When itis not possible to determine ifthere

is a single melanoma or multiple

melanomas, opt for a single melanoma and

abstract as a single primary.

Note: Use this rule only after all information

sourceshave 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

Melanomasin sites with ICD-O-3

topography codesthat are different atthe

second (Cxxx),third (Cxxx) or fourth (C44x)

character are multiple primaries.


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M4

Melanomas withdifferent 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 ofthe rightside of

the chest and a melanoma at midline ofthe

chest are different laterality, multiple

primaries.


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M4 Examples

Example 2: A melanoma ofthe rightside of

the chest and a melanoma ofthe leftside of

the chest are multiple primaries.


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M5

Melanomas with ICD-O-3histology codes

that are different atthe first (xxxx),second

(xxxx) orthird number (xxxx) are multiple

primaries.


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M6

An invasive melanoma that occursmore

than 60 days afteran in situ melanoma is

a multiple primary.


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M6Notes

Note 1: The purpose ofthis rule isto ensure

thatthe case iscounted as an incident

(invasive) case when incidence data are

analyzed.


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M6Notes

Note 2:Abstract as multiple primaries even

ifthe medical record/physician statesitis

recurrence or progression of disease.


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M7

Melanomas diagnosed more than 60 days

apart are multiple primaries.


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M8

Melanomasthatdo not meet any ofthe

above criteria are abstracted as a single

primary.


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M8Notes

Note 1: Use the data item Multiplicity

Counter to record the number of

melanomas abstracted as a single primary.


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M8Notes

Note 2: When an invasive melanoma

follows an in situ melanoma within 60 days,

abstract as a single primary.

Note 3:All casescovered by this rule are

the same site and histology.


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M8 Examples

ThisisNOT intended to be an exhaustive

set of examples;there are othercasesthat

may be classified as a single primary.

Warning: Usingonlythese case

examples to determine the numberof

primaries canresultinmajorerrors.


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M8 Examples

Example 1: Solitary

melanoma on the left backand another solitary

melanoma on the left chest

Example 2: Solitary

melanoma on the right thighand another solitary

melanoma on the right

ankle


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Histology Coding Rules


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Single Melanoma or Multiple

Melanomas Abstracted as aSingle Primary


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H1

Code the histology documented by the

physician when there isno

pathology/cytology specimen orthe

pathology/cytology reportisnot available.


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H1 Notes

Note 1: Priority forusing documentsto

code the histology

Documentation in the medical record thatrefersto pathologic orcytologic findings

Physicians reference to type of melanoma

in the medical record

PET scan


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H1 Notes

Note 2: Code the specifichistology when

documented.


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H2

Code the histology from the metastaticsite

when there isno 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 isidentified.


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H4

Code the invasive histologictype when there

are invasive and in situ components.


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H5

Code the histologictype when the diagnosis

is regressing melanoma and a histologic

type.

Example: Nodular melanoma with features

of regression. Code 8721 (Nodular

melanoma).


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H6

Code 8723 (Malignant melanoma,

regressing) when the diagnosisis

regressing melanoma.

Example: Malignant melanoma with

features of regression. Code 8723.


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H7

Code the histologic type when the

diagnosisislentigo maligna melanoma

and a histologic type.


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H8

Code 8742 (Lentigo maligna melanoma)

when the diagnosisislentigo maligna

melanoma


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H9

Code the mostspecific histologicterm

when the diagnosisis melanoma,NOS

(8720) with a single specifctype.


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H9Notes

Note 1: The specifictype forin situ lesions

may be identified as pattern, architecture,

type,subtype, predominantly, with features

of, major, or with ____differentiation


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H9Notes

Note 2: The specifictype forinvasive

lesions may be identified astype,subtype,

predominantly, with features of, major, or

with ____differentiation


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H10

Code the histology withthe numerically

higherICD-O-3code.


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MP/H Task Force

melanoma by abhishek jaguessar

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