Lymph Nodes Head and Neck Levels I-III
Description
Lymph Nodes for Head and Neck, Levels I-III records the involvement of Levels I-III lymph nodes. This data item is used to code the presence or absence of lymph node involvement in head and neck levels I-III. The definitions of the levels are the same for all applicable head and neck sites. * Note: This data item was previously collected for all head and neck sites. It is now only clinically relevant for unknown head and neck primaries with positive cervical (head and neck) lymph nodes and mucosal melanomas of the head and neck. **Level I** is subdivided into levels IA and IB, which contain the submental and submandibular triangles bounded by the anterior and posterior bellies of the digastric muscle, the hyoid bone inferiorly, and the body of the mandible superiorly. Lymph node chains at this level: * Submental (Level IA), submandibular (Level IB), submaxillary (Level IB) **Level II** is subdivided into levels IIA and IIB, which contain the upper jugular lymph nodes and extend from the level of the skull base superiorly to the hyoid bone inferiorly. A vertical plane defined by the spinal accessory nerve is the boundary between level IIA (anterior to spinal accessory nerve) and IIB (posterior to spinal accessory nerve). Lymph node chains at this level: * Jugulodigastric (subdigastric), upper deep cervical, upper jugular **Level III** contains the middle jugular lymph nodes from the hyoid bone superiorly to the level of the lower border of the cricoid cartilage inferiorly. Lymph node chains at this level: * Middle deep cervical, mid-jugularNotes
**Note 1:** **Physician Statement** * Physician statement of Levels I-III lymph node involvement can be used to code this data item when no other information is available. **Note 2:** **Related data items** * 3876: LN Head and Neck Levels I-III * 3877: LN Head and Neck Levels IV-V * 3878: LN Head and Neck Levels VI-VII * 3879: LN Head and Neck Other **Note 3:** **Priority order** * Pathological information takes priority over clinical.| Code | Description |
|---|---|
| 0 | No involvement in Levels I, II, or III lymph nodes |
| 1 | Level I lymph node(s) involved |
| 2 | Level II lymph node(s) involved |
| 3 | Level III lymph node(s) involved |
| 4 | Levels I and II lymph nodes involved |
| 5 | Levels I and III lymph nodes involved |
| 6 | Levels II and III lymph nodes involved |
| 7 | Levels I, II and III lymph nodes involved |
| 8 | Not applicable: Information not collected for this case (If this item is required by your standard setter, use of code 8 will result in an edit error) |
| 9 | Not documented in medical record Positive nodes, but level of positive node(s) unknown Lymph node levels I-III not assessed, or unknown if assessed |