- Malignant neoplasms primary, inaccurately indicated and unspecified localization
Sections C76-C80 include malignant neoplasms with inaccurate primary localization or those defined as “disseminated,” “scattered,” or “common” without indication of primary localization. In both cases, primary localization is considered unknown.
- Functional activity
Class II are classified as neoplasms, regardless of the presence or absence of functional activity in them. If it is necessary to clarify the functional activity associated with a particular neoplasm, an additional code from class IV can be used. For example, a catecholamine-producing malignant pheochromocytoma of the adrenal gland is coded under rubric C74 with an additional code E27.5; basophilic pituitary adenoma with Itsenko -Cushing's syndrome is coded under rubric D35.2 with additional code E24.0.
There are a number of large morphological (histological) groups of malignant neoplasms: carcinomas, including squamous and adenocarcinomas; sarcomas; other soft tissue tumors, including mesothelioma; lymphomas (Hodgkin and non-Hodgkin); leukemia; other specified and specific localization types; unspecified cancers.
The term "cancer" is generic and can be used for any of the above groups, although it is rarely used in relation to malignant neoplasms of lymphoid, hematopoietic and related tissues. The term "carcinoma" is sometimes misused as a synonym for the term "cancer".
In class II, neoplasms are classified mainly by localization within wide groups, based on the nature of the course. In exceptional cases, morphology is indicated in the names of headings and subheadings.
For those who want to identify the histological type of neoplasm, a general list of individual morphological codes is given . Morphological codes are taken from the second edition of the International Classification of Diseases in Oncology (ICD-O), which is a biaxial classified system that provides independent coding of neoplasms according to topography and morphology.
Morphological codes have 6 characters, of which the first four determine the histological type, the fifth indicates the nature of the tumor (malignant primary, malignant secondary, i.e. metastatic, in situ, benign, indefinite), and the sixth sign determines the degree of differentiation of solid tumors and is also used as a special code for lymphomas and leukemia.
- Using subheadings in class II
It is necessary to pay attention to the special use in this class of subheadings with the sign .8 (see Note 5). Where it is necessary to allocate a subheading for the group "others", usually use a subheading .7.
- Malignant neoplasms that go beyond one localization, and the use of a subheading with a fourth sign .8 (lesions that go beyond one or more of these localizations)
Sections C00-C75 classify primary malignant neoplasms in accordance with the place of their occurrence. Many three-digit headings are further subdivided into sub-headings in accordance with the various parts of the bodies in question. A neoplasm that captures two or more adjacent localizations within a three-digit heading and whose origin cannot be determined, should be classified by a subheading with the fourth sign .8 (a lesion that extends beyond one or more of the above localizations), if
such a combination is not specifically indexed in other sections. For example, carcinoma of the esophagus and stomach is indicated by the code C16.0 (cardia), while carcinoma of the tip and lower surface of the tongue must be encoded with the subheading C02.8. On the other hand, carcinoma of the tip of the tongue with involvement of its lower surface should be encoded in the C02.1 subheading, since the place of occurrence (in this case, the tip of the tongue) is known.
- Malignant neoplasms of ectopic tissue should be encoded in accordance with the mentioned localization.
- When coding neoplasms, in addition to their localization, the morphology and nature of the course of the disease should be taken into account, and first of all, it is necessary to refer to the Alphabetical Index for a morphological description.
C00-C97 Malignant Neoplasms
D00-D09 INNITIONS IN SITU
Note. Many in situ neoplasms are seen as sequential morphological changes between dysplasia and invasive cancer. For example, for cervical intraepithelial neoplasia (CIN), three degrees are recognized, of which the third (CIN III) includes both severe dysplasia and in situ carcinoma. This gradation system is also extended to other organs, such as the vulva and vagina. A description of grade III intraepithelial neoplasia with or without indication of severe dysplasia is presented in this section; Grades I and II are classified as dysplasia of the involved organ systems and should be coded according to the classes corresponding to these organ systems.
Included: Bowen's disease erythroplasia morphological codes with the character code of the neoplasm / 2 erythroplasia of Keir
D10-D36 BENEFICIAL EDUCATIONS
Included: morphological codes with the character code of the neoplasm / 0
Note. Sections D37-D48 are classified by the location of neoplasms of an uncertain or unknown nature (i.e., neoplasms that raise doubts about whether they are malignant or benign). In the classification of tumor morphology, such neoplasms are encoded by their character code / 1.