Schema Discriminator 1 (Soft Tissue Other)

Note Schema Discriminator for C760

• This schema discriminator is used to discriminate between head and neck tumors with unknown primary site coded as C760.

• 00060 Cervical Lymph Nodes and Unknown Primary

Occult head and neck tumor with cervical metastasis in Levels I-VII, and other group lymph nodes without a p16 immunostaining or with negative results and without an Epstein-Barr virus (EBV) encoded small RNAs (EBER) by in situ hybridization performed or with negative results are staged using the AJCC Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck Staging System. Assign primary site C760; code the schema discriminator accordingly.

• 00090 Nasopharynx

Occult head and neck tumors with cervical metastasis in Levels I-VII, and other group lymph nodes that is positive for Epstein-Barr virus (EBV+) (regardless of p16 status) encoded small RNAs (EBER) identified by in situ hybridization are staged using the AJCC Nasopharynx Staging System. *Assign primary site C119; do NOT code this discriminator. *

• 00100 HPV-Mediated (p16+) Oropharyngeal Cancer

Occult head and neck tumors with cervical metastasis in Levels I-VII, and other group lymph nodes, p16 positive with histology consistent with HPV-mediated oropharyngeal carcinoma (OPC), are staged using the AJCC HPV-Mediated (p16+) Oropharyngeal Cancer Staging System. Assign primary site C109; do NOT code this discriminator

• 99999 Ill-Defined Other

If the tumor is not occult or does not have cervical metastasis in Levels I-VII, and other group lymph nodes, it is not included in the AJCC Cervical Lymph Nodes and Unknown Primary Tumors of the Head and Neck Staging System and will be classified as Ill-Defined Other for Summary Staging

Positive p16 in head and neck regional nodes, EBV unknown or negative
Assign primary site C109

Positive EBV in head and neck regional nodes, p16 positive, negative, or unknown
Assign primary site C119|Various

00010: Oropharynx HPV-Mediated (p16+)

00090: Nasopharynx|