Note: For the CS Extension codes 10, 20, 30, 40, 50, 80, and 99 that cross with Site Specific Factor 1 and 2 and Extra Table 1: Thickness and Ulceration.
The CS extra tables are additional tables present in some schemas beyond the standard ones that are used in every schema. They have different purposes and structures, often serving as a means of bringing additional variables into the determination of staging codes.
In coding malignant melanoma for example the CS Extension table in particular codes 10 - 80, and 99 ONLY, the T code is assigned based on value of CS Site Specific Factor 1, Measured Thickness and CS Site Specific Factor 2, Ulceration and Extra Table 1: Thickness and Ulceration and Extra Table 2: Extension and Ulceration (See tables below).
Note 1: If there is a discrepancy between the Clark level and the pathologic description of extent, use the higher (more extensive) code.
Note 2: Satellite or in-transit metastasis are coded under CS Lymph Nodes.
| Code | Description | TNM | SS77 | SS2000 |
|---|---|---|---|---|
| 00 | In situ: Noninvasive; intraepidermal Clark level I Basement membrane of the epidermis is intact |
Tis | IS | IS |
| 10 | Papillary dermis invaded Clark level II |
* | L | L |
| 20 | Papillary-reticular dermal interface invaded Clark level III |
* | L | L |
| 30 | Reticular dermis invaded Clark level IV |
* | L | L |
| 40 | Skin/dermis, NOS Localized, NOS |
* | L | L |
| 50 | Subcutaneous tissue invaded (through entire dermis) Clark level V |
* | L | RE |
| 80 | Further contiguous extension: Underlying cartilage, bone, skeletal muscle |
* | D | D |
| 95 | No evidence of primary tumor | T0 | U | U |
| 99 | Unknown extension Primary tumor cannot be assessed (e.g., shave biopsy or regressed melanoma) Not documented in patient record |
* | U | U |
Extra Table Instructions: For Extension codes 10 - 80, and 99 ONLY, the T code is assigned based on value of CS Site Specific Factor 1, Measured Thickness and CS Site Specific Factor 2, Ulceration and Extra Table 1: Thickness and Ulceration and Extra Table 2: Extension and Ulceration.
Note: Code MEASURED THICKNESS (Depth) of tumor (Breslow measurement), not size. Record actual measurement in millimeters from Pathology Department.
| Code | Description |
|---|---|
| 000 | No mass/tumor found |
| 001 - 988 | 0.01 - 9.88 millimeters Code exact measurement in HUNDREDTHS of millimeters. Examples:
|
| 989 | 9.89 millimeters or larger |
| 990 | Microinvasion; microscopic focus or foci only; no size given |
| 999 | Unknown; size not stated Not documented in patient record |
Note: Melanoma ulceration is the absence of an intact epidermis overlying the primary melanoma based upon histopathological examination.
| Code | Description |
|---|---|
| 000 | No ulceration present |
| 001 | Ulceration present |
| 999 | Unknown Not stated Not documented in patient record |
Note: For CS Extension codes 10 - 80 and 99 ONLY, the T code is assigned based on cross tabulation of thickness from Site Specific Factor 1 and ulceration from Site Specific Factor 2.
| SSF 1 Thickness range from: | SSF 1 Thickness range to: | SSF 2 Ulceration 000 | SSF 2 Ulceration 001 | SSF 2 Ulceration 999 |
|---|---|---|---|---|
| 000 | 000 | TX | TX | TX |
| 001 | 100 | * | * | * |
| 101 | 200 | T2a | T2b | T2NOS |
| 201 | 400 | T3a | T3b | T3NOS |
| 401 | 989 | T4a | T4b | T4NOS |
| 999 | 999 | TX | TX | TX |
Extra Table Notes: For values that cross tabulate to *, the T code is assigned based on the Extra Table 2: Extension and Ulceration.
Note: For the CS Extension codes 10, 20, 30, 40, 50, 80, and 99 that cross with Site Specific Factor 1 and 2 and Extra Table 1: Thickness and Ulceration.
| For CS Extension | SSF 2 Ulceration 000 | SSF 2 Ulceration 001 | SSF 2 Ulceration 999 |
|---|---|---|---|
| 10 | T1a | T1b | T1NOS |
| 20 | T1a | T1b | T1NOS |
| 30 | T1b | T1b | T1b |
| 40 | T1NOS | T1b | T1NOS |
| 50 | T1b | T1b | T1b |
| 80 | T1b | T1b | T1b |
| 99 | T1b | T1b | T1b |