Extranodal Exten H&N Clin (Buccal Mucosa)

Organization	Field Name	ID#	ID Name	Required

Organization	Field Name	ID#	ID Name	Required
KCR	Extranodal Extension Head and Neck Clinical	34030	ENExtHeadNeckClin	yes
SEER	Extranodal Exten H&N Clin	3831	extranodalExtensionHeadNeckClin	yes

Note 1 Physican Statement

Physician statement of extranodal extension (ENE) clinically or physician clinical stage indicating the absence or presence of ENE can be used to code this data item when no other information is available
Physical exam alone is sufficient to determine Clinical ENE

Note 2 Clinical assessment criteria

The assessment of ENE must be based on evidence acquired prior to definitive surgery of the primary site, chemotherapy, radiation, or other type of treatment, i.e., the clinical timeframe for staging.
The assessment for ENE in addition to physical examination may include imaging, biopsy of the regional lymph node, and/or biopsy of tissues surrounding the regional lymph node
Fixed or matted nodes are clinical indications of ENE
Imaging alone is not enough to determine or exclude ENE
Note that the rules for coding ENE for head and neck sites compared to non-head and neck sites are different.

Code	Description

Code	Description
0	Regional lymph node(s) involved, ENE not present/not identified during diagnostic workup
1	Regional lymph node(s) involved, ENE present/identified during diagnostic workup, based on physical exam WITH or WITHOUT imaging
2	Regional lymph node(s) involved, ENE present/identified during diagnostic workup, based on microscopic confirmation
4	Regional lymph nodes involved, ENE present/identified, unknown how identified
7	No lymph node involvement during diagnostic workup (cN0) Non-invasive neoplasm (behavior /2)
8	Not applicable: Information not collected for this case (If this information is required by your standard setter, use of code 8 may result in an edit
9	Not documented in medical record ENE not assessed during diagnostic workup, or unknown if assessed Clinical assessment of lymph node(s) not done, or unknown if done

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