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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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Equivalent Terms, Definitions
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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Equivalent Terms, Definitions
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
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