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Produced: 05/26/2026 7:09 AM
Question 20180076
Inquiry Details
References:
Solid Tumor Rules. Head and Neck
Question:
Solid Tumor Rules (2018)/Histology--Head & Neck: Where does cytology rank on the Priority Order for Using Documentation to Identify Histology for Head and Neck primaries? See Discussion.
Discussion:
Cytology is not listed in the Priority Order for Using Documentation to Identify Histology (Histology Coding Rules) in the Head and Neck schema. Other schemas do include cytology in the hierarchy below tissue from a biopsy or resection. Cytology is often less specific than histology, so one would expect cytology to be listed below tissue in this hierarchy. Was this an oversight? Or would cytology be equivalent to histology if it provided the most specific histology for the case?
Answer:
Instruction #5 in the Priority Order for Using Documentation to Identify Histology of the Head and Neck Solid Tumor Rules, Item 5.B., refers to cytology in the documentation though cytology is not listed before this. In H&N tumors, cytology is usually performed on lymph nodes and seldom on a primary tumor. Cytology will be added to H&N in the next update.
