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Produced: 02/07/2026 12:57 AM
Question 20130214
Inquiry Details
References:
Heme & Lymph Manual & DB
Question:
Primary site--Heme & Lymphoid Neoplasms: Does Rule PH20 apply if a patient with lymphoma has bilateral axillary and bilateral inguinal lymph node involvement?
Discussion:
Rule PH20 states to code the primary site to the specific lymph node region when multiple lymph node chains within the same region as defined by ICD-O-3 are involved. Note 1 further states that one is to use this rule when there is bilateral involvement of lymph nodes.
Answer:
Rule PH21 applies to this situation which states to code the primary site to multiple lymph node regions, NOS (C778) when multiple lymph node regions, as defined by ICD-O-3, are involved and it is not possible to identify the lymph node region where the lymphoma originated. Axillary nodes are coded to C773 and inguinal nodes are coded to C774. There are two lymph node regions involved. Code the primary site to C778 [multiple lymph nodes].
If this patient had only bilateral axillary OR only bilateral inguinal nodes are involved, then PH20 would have applied and you would code to the specific lymph node region mentioned.
Cancer Site Category:
Heme & Lymphoid Neoplasms
Data Item Category:
Primary site
Other Category:
N/A
Year:
2013
