Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
This document provides information on changes between the 2010, 2012 and 2014 editions of the Hematopoietic and Lymphoid Neoplasm Manual. Starting
January 1, 2014, only one manual for diagnosis years 2010 and forward will be available and will be referred to as the “Hematopoietic and Lymphoid Neoplasm
Manual,” and be effective for cases diagnosed 2010 and forward. The information contained in this document will help you to make sure that your data is coded
consistently and where and why the changes were made.
Note: SEER is not requiring review of data already collected. This document was developed to help registrars know where the differences are. Applicable SINQ
questions will be updated to reflect that the manual applies to questions 2010 and forward.
Hematopoietic Rules for cases diagnosed 2010+
Rule M1: Abstract a single primary when minimal
information is available
Rule M2: Abstract a single primary when there is a single
histology
Rule M3: For the following neoplasms, abstract a single
primary* when a sarcoma is diagnosed either
simultaneously or after a leukemia of the same lineage *
Mast cell sarcoma diagnosed simultaneously with mast
cell leukemia or after mast cell leukemia* Myeloid
sarcoma diagnosed simultaneously with acute myeloid
leukemia/myelomonocytic leukemia or diagnosed after
acute myeloid leukemia/myelomonocytic leukemia
Rule M4: Abstract a single primary* when a specific MDS
subtype is followed by a different specific MDS subtype
Rule M5: Abstract a single primary* when both follicular
lymphoma (FL) and diffuse large B-cell lymphoma
(DLBCL) are simultaneously present in the same
anatomic location(s). FL and DLBCL may be present in
*Same lymph node region(s) AND/OR * Same organ(s)
AND/OR Same tissue(s)
Rule M6: Abstract a single primary* when two or more
types of non-Hodgkin lymphoma are simultaneously
present in the same anatomic location
Multiple Primary (M) Rules
Original Hematopoietic Rules
Rule M1: Abstract as a single primary when
minimal in formation is available (such as a death
certificate only (DCO) case or a pathology-reportonly case). *
Rule M2: Abstract as a single primary when there is
a single histology
Comments
Same rule for 2010, 2012 and 2014 versions
Same rule for 2010, 2012 and 2014 versions
2012: new rule, no changes 2014
2012: new rule, no changes 2014
2012: new rule, no changes 2014
Rule M3: Abstract as a single primary when two or
more types of non-Hodgkin lymphoma are present
in the same anatomic location(s) such as one
Same rule for 2010, 2012 and 2014 versions
Different number starting in 2012
Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Rule M7: Abstract a single primary* when both Hodgkin
and non-Hodgkin lymphoma are simultaneously present
in the same anatomic location(s). Hodgkin and nonHodgkin may be present in the same lymph node or
same lymph node region(s)(s), the same organ(s), and/or
the same tissue(s)
Rule M8 Abstract as multiple primaries** when Hodgkin
lymphoma is diagnosed in one site and non-Hodgkin
lymphoma is diagnosed in another site(s)
Rule M9: Abstract a single primary* when a more
specific histology is diagnosed after an NOS ONLY when
the Heme DB Multiple Primaries Calculator confirms that
the NOS and the more specific histology are the same
primary
Rule M10: Abstract the acute neoplasm as a single
primary* when both a chronic and an acute neoplasm
are diagnosed simultaneously AND there is
documentation of only one positive bone marrow
biopsy, lymph node biopsy, or tissue biopsy
Rule M11: Abstract a single primary* and code the later
histology when both a chronic and an acute neoplasm
are diagnosed simultaneously or less than or equal to 21
days apart AND there is no available documentation on
Multiple Primary (M) Rules
Original Hematopoietic Rules
lymph node, one organ, or one tissue.*
Rule M4: Abstract as a single primary when both
Hodgkin and non Hodgkin lymphoma are present in
the same anatomic location(s). Hodgkin and nonHodgkin may be present in one lymph node, one
organ, or one tissue.*
Rule M5: Abstract as multiple primaries when any
of the following situations are met ** • Hodgkin
lymphoma in one node and non-Hodgkin
lymphoma in a different node Note : The involved
nodes may be in the same lymph node region as
defined by ICD -O-3 or in different lymph node
regions as defined by ICD-O-3. See Appendix C
•Hodgkin lymphoma in one organ and non Hodgkin
lymphoma in a different organ •Hodgkin lymphoma
in tissue and non Hodgkin lymphoma in different
tissue
Rule M6: Abstract as a single primary when a more
specific histology is diagnosed after NOS when the
Hematopoietic DB Multiple Primaries Calculator
confirms that the NOS and the more specific
histology are the same primary.
Rule M7: Abstract as a single primary when both
the chronic and the acute phase of the neoplasm
are diagnosed within 21 days AND * • There is
documentation of one positive bone marrow
biopsy
Rule M9: Abstract as a single primary when both
the chronic and the acute phase of the neoplasm
are diagnosed within 21 days AND * • There is no
available documentation on bone marrow biopsy
Comments
Same rule for 2010, 2012 and 2014 versions
Different number starting in 2012
Same rule for 2010, 2012 and 2014 versions
Different number starting in 2012
Same rule for 2010, 2012 and 2014 versions
Different number starting in 2012
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Different number starting in 2012
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Different number starting in 2012
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
bone marrow biopsy, lymph node biopsy, or tissue
biopsy.
Rule M12: Abstract as multiple primaries** when a
neoplasm is originally diagnosed as a chronic (less
aggressive) neoplasm AND there is a second diagnosis of
an acute neoplasm more than 21 days after the chronic
diagnosis
Rule M13: Abstract as multiple primaries** when both a
chronic and an acute neoplasm are diagnosed
simultaneously or less than or equal to 21 days apart
AND there is documentation of two bone marrow
examinations, lymph node biopsies, or tissue biopsies:
one confirming the chronic neoplasm and another
confirming the acute neoplasm.
Rule M14: Abstract the acute neoplasm as a single
primary* when a neoplasm is originally diagnosed as
acute AND reverts to a less aggressive/chronic neoplasm
AND there is no confirmation available that the patient
has been treated for the acute neoplasm
Rule M15: Abstract multiple primaries** when a
neoplasm is originally diagnosed as acute AND reverts to
a less aggressive/chronic neoplasm after treatment
Rule M16: Abstract a single primary when posttransplant lymphoproliferative disorder and any B-cell
lymphoma, T-cell lymphoma, Hodgkin lymphoma or
plasmacytoma is diagnosed simultaneously (See Rule
PH2)
Rule M17: Use the Heme DB Multiple Primaries
Calculator to determine the number of primaries for all
Multiple Primary (M) Rules
Original Hematopoietic Rules
Comments
Rule M10: Abstract as multiple primaries when a
neoplasm is originally diagnosed in a chronic (less
aggressive) phase AND second diagnosis of a blast
or acute phase more than 21 days after the chronic
diagnosis. **
Rule M8: Abstract as multiple primaries when both
the chronic and the acute phase of the neoplasm
are diagnosed within 21 days AND ** • There is
documentation of two bone marrow examinations,
one confirming the chronic neoplasm and another
confirming the acute neoplasm
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Different number starting in 2012
Rule M11: Abstract the acute phase as a single
primary when a neoplasm is originally diagnosed in
the blast or acute phase and reverts to a less
aggressive/chronic phase and there is no
confirmation available that the patient has been
treated.
Rule M12: Abstract as multiple primaries when a
neoplasm is originally diagnosed in the blast or
acute phase and reverts to a less aggressive/
chronic phase after treatment.
None
Same rule for 2010, 2012 and 2014 versions.
Different number starting in 2012
Rule M13: Use the Hematopoietic DB to determine
the number of primaries for all cases that do not
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Different number starting in 2012
Same rule for 2010, 2012 and 2014 versions.
Different number starting in 2012
This was originally handled through
transformations. All transformations were
removed for PTLD (9971/3). To ensure that
the simultaneous diagnosis of PTLD and an
accompanying lymphoma were coded as one
primary, this rule was added
Same rule for 2010, 2012 and 2014 versions.
Different number in 2012 and different
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
cases that do not meet the criteria of M1-M16.
Multiple Primary (M) Rules
Original Hematopoietic Rules
meet the criteria of M1 M12.
Comments
number in 2014
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Rule PH1 : Code the primary site to the site of origin,
lymph node region, tissue, or organ, and code the
histology post-transplant lymphoproliferative disorder
9971/3 when the diagnosis is only post-transplant
lymphoproliferative disorder
Rule PH2: Code the primary site to the site of origin,
lymph node region, tissue, or organ, and code the
histology of the accompanying lymphoma or
plasmacytoma when the diagnosis is post-transplant
lymphoproliferative disorder and any B-cell lymphoma,
T-cell lymphoma, Hodgkin lymphoma, or plasmacytoma
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
Rule PH1: Code the primary site using information
from scans, documentation in the medical record,
the pathology report, and from the Hematopoietic
DB.
Rule PH2: Code the histology diagnosed by the
definitive diagnostic method (s) (see Hematopoietic
DB). The definitive diagnostic method can be a
clinical diagnosis, genetic test,
immunophenotyping, cytology, or pathology. When
a pathology report is the definitive diagnostic
method, code the histology from the final
diagnosis, comment on the final diagnosis, addenda
to the final diagnosis, or CAP protocol
Rule PH3: Code the primary site and histology using
the medical practitioner’s statement on the
medical record or death certificate when none of
the tests or reports defined as a definitive
diagnostic method is available.
Comments
The first three rules in 2010 were deleted.
This information was incorporated into other
parts of the manual. Should not have an
affect on reportability, diagnostic method,
primary site or histology
2012: new rule, no changes 2014
2012: new rule, no changes 2014
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Rule PH3: Code the primary site to the site of origin,
lymph node region, tissue, or organ, and code the
histology extramedullary plasmacytoma 9734/3 when
any of the following occur in a site other than bone
Rule PH4: Code the primary site to the specific bone
C400-C419 where the plasmacytoma originated and
code the histology solitary plasmacytoma of bone
9731/3 when the diagnosis is
Rule PH5: Code the primary site bone, NOS C419 and
histology solitary plasmacytoma, NOS 9731/3 when the
only information is that the patient had a plasmacytoma,
NOS or a solitary plasmacytoma, NOS.
Rule PH6: Code the primary site bone marrow C421 and
the histology plasma cell myeloma/multiple myeloma
9732/3 when the clinical diagnosis is plasma cell
myeloma/multiple myeloma and there is no
documentation of bone marrow biopsy or the results of
the bone marrow biopsy are unknown or unavailable
Rule PH7: Code the primary site bone marrow C421 and
the histology plasma cell myeloma/multiple myeloma
9732/3 when the diagnosis is evolving myeloma,
indolent myeloma, multiple myeloma, plasma cell
leukemia, plasma cell myeloma, smoldering myeloma
Rule PH8: Code the primary site as indicated in the
following bullets and code the histology chronic
lymphocytic leukemia/small lymphocytic lymphoma
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
Rule PH4: Code the primary site to the site of
origin, (lymph node region(s), tissue, or organ) and
code the histology extramedullary plasmacytoma
(9734/3) when any of the following occur in a site
other than bone
Rule PH5: Code the primary site to the specific
bone (C400 -C419) where the plasmacytoma
originated and code the histology solitary
plasmacytoma of bone (9731/3) when the diagnosis
is
Rule PH6: Code the primary site unknown
(C809)and histology solitary plasmacytoma of bone
(9731/3 when the only information is that the
patient had a plasmacytoma or a solitary
plasmacytoma
Rule PH7: Code the primary site bone marrow
(C421) and the histology plasma cell
myeloma/multiple myeloma (9732/3) when the
clinical diagnosis is plasma cell myeloma/multiple
myeloma and there is no documentation of bone
marrow biopsy or the results of the bone marrow
biopsy are unknown or unavailable.
Rule PH10: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
code the histology small B lymphocytic Lymphoma
Comments
Same rule for 2010, 2012 and 2014 versions.
Different number starting in 2012
2014: Plasma cell neoplasm deleted
Same rule for 2010, 2012 and 2014 versions.
Different number starting in 2012
2014: Plasma cell neoplasm deleted
Change in assignment of primary site. Code
C809 in 2010 when no information available,
code to C419 in 2012.
May need registrars to check on 9731/3 with
primary site C809 and change to C419
No changes in 2014
New rule to 2012; clarifies how to code
primary site for multiple myeloma when no
bone marrow biopsy information is available
No changes in 2014
Same rule for 2010, 2012 and 2014 versions.
Different number starting in 2012
2012: Code 9670/3 became obsolete and
only 9823/3 used for CLL/SLL.
2014: Edit changed to allow 9823/3 to use
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
CLL/SLL 9823/3 when the diagnosis is CLL, SLL, or
CLL/SLL.
Rule PH9: Code the primary site bone marrow C421
when the only site involved is bone marrow. Code the
histology using the list below. Histologies (9811-9818,
9827, 9837)
Rule PH10: Code the primary site to the site of origin
when lymph nodes or lymph node regions), OR tissue or
tissues, or an organ or organs are involved. Code the
histology using the list below. Histologies (9811-9818,
9827, 9837)
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
(9670/3) when the diagnosis is B -cell chronic
lymphocytic leukemia/small lymphocytic lymphoma
AND you cannot verify that the disease originated
in the bone marrow.
Rule PH11: Code the primary site bone marrow
(C421) and the respective histology from the list
below when the diagnosis is Burkitt
lymphoma/leukemia, precursor cell lymphoblastic
lymphoma/leukemia, precursor B-cell
1ymphoblastic leukemia/lymphoma, or precursor
T-cell lymphoblastic leukemia/lymphoma AND the
only involvement is bone marrow. • Burkitt cell
leukemia (9826/3) • Precursor cell lymphoblastic
leukemia, NOS (9835/3) •Precursor B-cell
lymphoblastic leukemia/lymphoma (9836/3) •T
lymphoblastic leukemia/lymphoma (9837/3)
Rule PH12: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
the histology to the respective histology from the
list below when the diagnosis is Burkitt
lymphoma/leukemia , precursor cell lymphoblastic
lymphoma/leukemia, precursor B-cell
lymphoblastic leukemia/lymphoma, or precursor Tcell lymphoblastic leukemia/lymphoma AND there
is involvement of lymph node region(s), tissue, or
organ(s).• Burkitt lymphoma, NOS (9687/3)•Blastic
plasmacytoid dendritic cell neoplasm(previously
called precursor cell lymphoblastic lymphoma,
NOS) (9727/3) •
Precursor B -cell lymphoblastic lymphoma, NOS
(9728/3) •Precursor T-cell lymphoblastic
lymphoma, NOS (9729/3)
Comments
back to 2010
In 2010 database, 9811-9818 were
automatically assigned primary site C421.
This was changed in 2012 and they are now a
leukemia/lymphoma depending on the
primary site
The following histologies were made obsolete
in the 2012 database, but were obsolete
effective 2010: 9835, 9836, 9837
Burkitt leukemia (9826) is no longer covered
in a rule, is automatically assigned primary
site C421
No changes in 2014
See notes for 2012 Rule PH9
No changes in 2014
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Primary Site/Histology (PH) RULES
Hematopoietic Rules for cases diagnosed 2010+
Original Hematopoietic Rules
Comments
Rule PH11: Code the primary site bone marrow C421
Rule PH 13: Code the primary site bone marrow
Same rule for 2010, 2012 and 2014 versions.
and the histology myelodysplastic syndrome 9989/3
(C421) and the histology myelodysplastic syndrome Different number starting in 2012
when the diagnosis is preleukemia, smoldering leukemia, (9989/3) when the diagnosis is preleukemia,
or myelodysplastic syndrome
smoldering leukemia, or myelodysplastic syndrome.
Rule PH12: Code the primary site bone marrow C421
New rule for 2012. For 2014, need to make
and code the histology to mast cell leukemia 9742/3
sure there are no combinations of 9742/3
when the diagnosis is mast cell sarcoma AND there is a
and 9740/3 if 9742/3 was diagnosed first or
simultaneous or previous diagnosis of mast cell
simultaneously
leukemia.
Rule PH13: Code the primary site to the site of origin
See notes for 2012 Rule PH12
(usually soft tissue) and the histology to mast cell
No changes for 2014
sarcoma 9740/3 when the diagnosis is mast cell sarcoma
AND there is NO previous or simultaneous diagnosis of
mast cell leukemia
Rule PH14: Code the primary site bone marrow C421
Rule PH14: Code the primary site bone marrow
2012: Additional information added,
and code the histology acute myeloid leukemia, NOS or
(C421) and code the histology 9861/3 when the
including additional AML histologies that
any of the specific AML histologies 9840/3, 9861/3,
diagnosis is myeloid neoplasm or acute myeloid
could be used.
9865/3-9967/3, 9869/3, 9891/3, 9895/3-9898/3, 9910/3, leukemia NOS AND the involvement is limited to
2012 second edition: For the first 2012
9911/3 and 9931/3 when the diagnosis is myeloid
bone marrow.
version, there was a range of histologies
sarcoma AND there is a simultaneous or previous
added. This was corrected in the 2012,
diagnosis of acute myeloid leukemia.
version 2.
No changes in 2014
Rule PH15: Code the primary site to the site of origin
Rule PH15: Code the primary site to the site of
Same rule for 2010, 2012 and 2014 versions.
(usually soft tissue) and the histology to myeloid
origin (lymph node region(s), tissue, or organ and
Worded differently starting in 2012
sarcoma 9930/3 when the diagnosis is myeloid sarcoma
the histology to myeloid sarcoma (9930/3) when
AND there is no previous or simultaneous diagnosis of
the diagnosis is myeloid neoplasm or myeloid
acute myeloid leukemia
sarcoma AND the neoplasm originates s in a site
other than bone marrow.
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Rule PH16: Code the primary site to the site of origin,
lymph node(s ) or lymph node region(s) , tissue (s) or
organ (s) and code the Histology diffuse large B –cell
lymphoma (DLBCL ) 9680 /3 when DLBCL 9680/3 AND
Follicular lymphoma (NOS, grade 1, grade 2, or grade 3)
are present in the same lymph node(s) or lymph node
region (s) , the same organ (s) ,the same tissue (s) or
bone marrow.
Rule PH 17: Code the primary site to the site of Origin ,
lymph node (s) or lymph node region (s) , tissue (s) , or
organ(s) , and the histology to follicular lymphoma
Rule PH18: Code the primary site to skin C44_ and the
histology to primary cutaneous follicle Center cell
lymphoma 9597/3 when there is skin infiltration with
follicle cell lymphoma or B-cell lymphoma, follicle type
and the involvement is: • Limited to skin • Limited to
skin and the regional lymph node (s)
Rule PH19: Code the primary site to skin C44_ and the
histology to diffuse large B-cell lymphoma when there is
skin infiltration with large B-cell lymphoma or B-cell
lymphoma, large cell type and the involvement is: •
Limited to skin • Limited to skin and the regional lymph
node (s)
Rule PH20: Code the primary site to skin C44_ and the
histology to diffuse large B-cell lymphoma when there is
skin infiltration with B-cell lymphoma and the
involvement is: • Limited to skin • Limited to skin and
the regional lymph node (s)
Rule PH21: Code the primary site to the site of origin,
lymph node(s)or lymph node region(s) ,tissue(s),
organ(s) , or bone marrow and the histology B-cell
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
Rule PH16: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
code the histology diffuse large B-cell lymphoma
(DLBCL) (9680/3) when DLBCL (9680/3) and
follicular lymphoma (9690/3) are present in the
same lymph node (s),tissue, or organ
Rule PH17: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
the histology to follicular when the lymphoma is
described as diffuse follicular or follicular, diffuse
Rule PH18: Code the primary site to skin (C44_) and
the histology to follicle cell lymphoma (9597/3)
when there is skin infiltration with follicle cell
lymphoma or B-cell lymphoma, follicle type and the
involvement is limited to skin , or limited to skin
and the regional lymph nodes
Rule PH19: Code the primary site to skin (C44_) and
the histology to large B cell lymphoma (9680/3)
when there is skin infiltration with large B-cell
lymphoma or B-cell lymphoma, large cell type and
the involvement is limited to skin, or limited to skin
and the regional lymph nodes.
Rule PH20: Code the primary site to skin (C44_) and
the histology to B-cell lymphoma, NOS (9680/3)
when there is skin infiltration with B-cell lymphoma
and the involvement is limited to skin, or limited to
skin and the regional lymph nodes.
Rule PH21: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
the histology composite lymphoma (9596/3) when
Comments
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Same rule for 2010, 2012 and 2014 versions.
Worded differently starting in 2012
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
lymphoma, unclassifiable, with features intermediate
between diffuse large B-cell lymphoma and classical
Hodgkin lymphoma/composite Hodgkin and non
Hodgkin lymphoma 9596/3 when both non-Hodgkin
lymphoma and Hodgkin lymphoma are simultaneously
present in the same lymph node(s) or lymph node
region(s), tissue(s), organ(s), or bone marrow.
Rule PH22: Code the primary site to the site of origin,
lymph node (s) or lymph node region(s), tissue(s),
organ(s), or bone marrow and the histology to the NHL
with the numerically highest ICD -O-3 code when two or
more non-Hodgkin lymphomas are present in the same
lymph node(s) or lymph node region(s), tissue(s),
organ(s), or bone marrow.
Rule PH23: Code the primary site blood C420 and the
histology Waldenstrom macroglobulinemia 9761/3 when
there is lymphoplasmacytic lymphoma in the bone
marrow and IgM monoclonal gammopathy in the blood.
Rule PH24: Code the primary site to the involved bone
marrow, lymph nodes, or tissue and the histology
lymphoplasmacytic lymphoma 9671/3 when: the
diagnosis is Waldenstrom macroglobulinemia OR
lymphoplasmacytic lymphoma and Waldenstrom
macroglobulinemia AND the bone marrow, lymph nodes
OR lymphoid tissue are involved
Rule PH25: Code the primary site to the specific lymph
node region when only one lymph node or one lymph
node region is involved
Rule PH26: Code the primary site to mediastinal lymph
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
both non-Hodgkin lymphoma and Hodgkin
lymphoma are present in the same lymph node
region(s), tissue, or organ
Comments
Rule PH22: Code the primary site to the site of
origin (lymph node region(s), tissue, or organ) and
the histology to the numerically highest ICD-O-3
code when two or more non-Hodgkin lymphomas
are present in the same lymph node(s), tissue, or
organ.
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Rule PH23: Code the primary site blood (C420) and
the histology Waldenstrom macroglobulinemia
(9761/3) when there is lymphoplasmacytic
lymphoma in the bone marrow and IgM
monoclonal gammopathy in the blood.
Rule PH24: Code the primary site to the involved
bone marrow, lymph nodes, or lymphoid tissue and
the histology lymphoplasmacytic lymphoma
(9671/3) when the diagnosis is Waldenstrom
macroglobulinemia OR lymphoplasmacytic
lymphoma and Waldenstrom macroglobulinemia
AND the bone marrow, lymph nodes OR lymphoid
tissue are involved.
Rule PH25: Code the primary site to the specific
lymph node region when only one lymph node or
one lymph node region is involved
Rule PH26: Code the primary site mediastinal
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
nodes C771 when the site of lymphoma is described only
as a mediastinal mass.
Rule PH27: Code the primary site to intra - abdominal
lymph nodes C772 when the site of lymphoma is
described only as a retroperitoneal mass or only as a
mesenteric mass
Rule PH28: Code the primary site to inguinal lymph
nodes C774 when the site of lymphoma is described only
as an inguinal mass
Rule PH29: Code the primary site to the specific lymph
node region when multiple lymph node chains within the
same region as defined by ICD-O-3 are involved
Rule PH30: Code the primary site as multiple lymph
node regions, NOS C778, when multiple lymph node
regions, as defined by ICD-O-3, are involved and it is not
possible to identify the lymph node region where the
lymphoma originated.
Rule PH31: Code the primary site to lymph nodes, NOS
C779 when: • Multiple lymph node region (s) and
organ(s) are involved AND • No primary site (lymph node
region or organ) is identified.
Rule PH32: Code the primary site to bone marrow C421
when lymphoma is present only in the bone marrow
Rule PH33: Code the primary site to the organ when
lymphoma is present only in an organ.
Rule PH34: Code the primary site to the lymph node
region as defined by ICD -O-3 when there is proof of
extension from the regional lymph nodes into an organ
Rule PH35: Code the primary site to the organ when a
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
lymph nodes (C771) when the site of lymphoma is
described only as a mediastinal mass.
Rule PH27: Code the primary site intra--abdominal
lymph nodes (C772) when the site of lymphoma is
described only as a retroperitoneal mass or as a
mesenteric mass.
Rule PH28: Code the primary site inguinal lymph
nodes (C774) when the site of lymphoma is
described only as an inguinal mass.
Rule PH29: Code the primary site to the specific
lymph node region when multiple lymph node
chains within the same region (as defined by ICD-O3) are involved.
Rule PH30: Code the primary site as multiple lymph
node regions, NOS when multiple lymph node
regions (C778) as defined by ICD -O-3 are involved
and it is not possible to identify the lymph node
region where the lymphoma originated.
Rule PH31: Code the primary site to lymph nodes,
NOS (C779) when lymph node(s) are involved but
no primary site/particular lymph node region is
identified.
Rule PH32: Code the primary site to bone marrow
(C421) when lymphoma is present only in the bone
marrow.
Rule PH33: Code the primary site to the specific
organ when lymphoma is present only in an organ.
Rule PH34: Code the primary site to the lymph
node region as defined by ICD-O-3 when there is
proof of extension from the regional lymph nodes
into the organ.
Rule PH35: Code the primary site to the organ
Comments
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
Same rule for 2010, 2012 and 2014 versions.
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
lymphoma is present in an organ and that organ’s
regional lymph nodes
Rule PH36:Code the primary site to lymph nodes, NOS
C779 when: • Lymphoma is present in an organ and
lymph nodes that are not regional for that organ and the
origin cannot be determined even after consulting the
physician OR • Lymphoma is present in more than one
organ and the regional n odes for all organs involved OR
• More than one organ and some combination of
regional and distant nodes for the organs involved
Rule PH37:Code primary site to unknown primary site
C809 when there is no evidence of lymphoma in lymph
nodes AND the physician documents in the medical
record that he/she suspects that the lymphoma
originates in an organ ( s) OR multiple organ involvement
without any nodal involvement. See ICD -O-3 Rule D.
Rule PH38: Code primary site to involved lymph node(s)
or lymph node region(s) , organ (s) , or tissue (s) and the
histology to B- cell lymphoma, unclassifiable, with
features intermediate between diffuse large B -cell
lymphoma and classical Hodgkin lymphoma/composite
Hodgkin and non-Hodgkin lymphoma 9596/3 when any
Hodgkin AND non-Hodgkin lymphoma are diagnosed
simultaneously in t he same site , lymph node(s) or
lymph node region(s) , organ (s) , or tissue (s )
Rule PH39: Code the primary site to involved lymph
node(s) or lymph node region(s), o organ(s) or tissue (s)
and the histology to the higher numeric ICD -O-3 code
when two or more non–Hodgkin lymphomas are
diagnosed simultaneously in t he same site , lymph
node(s) or lymph node region(s), organ (s) , or tissue (s ).
Rule PH 38: Code the non-specific ( NOS ) histology
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
when lymphoma is present in an organ and that
organ’s regional lymph nodes.
Rule PH36: Code the primary site to lymph nodes,
NOS (C779) when lymphoma is present in an
organ(s) and lymph nodes that are not regional or
that organ and the origin cannot be determined
even after consulting the physician.
Rule PH37: Code primary site to unknown primary
site (C809) only when there is no evidence of
lymphoma in lymph nodes AND the physician
documents in the medical record that he/she
suspects that the lymphoma originates in an
organ(s). See ICD-O-3 Rule D.
Comments
Same rule for 2010, 2012 and 2014 versions.
Additional instructions added in 2012
Same rule for 2010, 2012 and 2014 versions.
Duplicate of Rule PH21. Deleted.
Duplicate of Rule PH22. Deleted
Rule PH38: Code the non-specific (NOS) histology
Same rule for 2010 and 2014 versions.
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
when the diagnosis is:•One non –specific histology AND
• Two or more specific histologies AND • The Heme DB
multiple primaries calculator documents the specific
histologies and NOS are the same primary AND • No
further information is available
Rule PH39: Code the specific histology when the
diagnosis is : • One non - specific (NOS) histology AND •
One specific histology AND •The Heme DB multiple
primaries calculator documents the specific histology
and NOS are the same primary
Rule PH40: Use the Heme DB to determine the primary
site and histology when rules PH1- PH 39 do not apply.
Rule PH41: Code the histology to the numerically higher
ICD -O-3 code when the histology code cannot be
determined using the Heme DB.
Primary Site/Histology (PH) RULES
Original Hematopoietic Rules
when the diagnosis is •One non-specific histology
AND •Two or more specific histologies AND• The
hematopoietic DB multiple primaries calculator
documents the specific histologies and NOS are the
same primary AND • No further information is
available
Rule PH39: Code the specific histology when the
diagnosis is •One non-specific (NOS) histology AND
• One specific histology AND •The Hematopoietic
DB multiple primaries calculator documents the
specific histology and NOS are the same primary
Rule PH40: Use the Hematopoietic DB to determine
the primary site and histology when rules PH1PH39 do not apply.
Rule PH41: When the histology code cannot be
determined using the Hematopoietic DB, code the
histology with the numerically higher ICD-O-3 code.
Comments
2012 version, Rule 40 due to duplicate rules.
Duplicate rules deleted 2014
Same rule for 2010 and 2014 versions.
2012 version, Rule 40 due to duplicate rules.
Duplicate rules deleted 2014
Same rule for 2010 and 2014 versions.
2012 version, Rule 40 due to duplicate rules.
Duplicate rules deleted 2014
Same rule for 2010 and 2014 versions.
2012 version, Rule 40 due to duplicate rules.
Duplicate rules deleted 2014
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Module 1: Module 1: Post-Transplant
Lymphoproliferative Disorder PH1 - PH2
Module Headings
Original Hematopoietic Rules
Module 1: General Instructions PH1-PH3
All hematopoietic and lymphoid neoplasms (9590/39992/3)
Comments
Module 1 from the original manual moved to
Module 9 in 2012.
Post-transplant lymphoproliferative disorder 9971/3
Module 2: Plasma Cell Neoplasms PH3 – PH7
Extraosseous plasmacytoma 9734/3
Plasma cell leukemia 9733/3
Plasma cell myeloma/multiple myeloma 9732/3
Solitary plasmacytoma of bone 9731/3
Module 3: Lymphoma/Leukemia (Specific neoplasms
that can manifest as either leukemia or lymphoma or
both leukemia and lymphoma) PH8 – PH10
(9727, 9811-9818, 9823, 9827, 9837)
Adult T-cell leukemia/lymphoma (HTLV-1 positive)
9827/3
Adult T-cell leukemia/lymphoma 9837/3
B Lymphoblastic leukemia/lymphoma with
hypodiploidy (Hypodiploid ALL) 9816/3
B Lymphoblastic leukemia/lymphoma with
t(1;19)(q23;p13.3);E2A-PBX1 (TCF3-PBX1) 9818/3
B Lymphoblastic leukemia/lymphoma with
t(12;21)(p13;q22); TEL-AML1 (ETV6-RUNX1) 9814/3
Module 2: Plasma Cell Neoplasms PH4-PH8
Solitary plasmacytoma of bone 9731/3
Plasma cell myeloma/multiple myeloma 9732/3
Extraosseous plasmacytoma 9734/3
9733/3 [OBS] added
Module 3: Lymphoma/Leukemia (Specific neoplasms
that can manifest as either leukemia or lymphoma)
PH9-PH12
Change in histologies listed due to change in
Rules PH9 and PH10
Blastic plasmacytoid dendritic cell neoplasm, NOS
9727/3
Burkitt cell leukemia 9826/3
Burkitt lymphoma, NOS 9687/3
Precursor B-cell lymphoblastic leukemia/lymphoma
9836/3
Precursor B-cell lymphoblastic lymphoma, NOS
9728/3
Precursor T-cell lymphoblastic lymphoma, NOS
9729/3
Small B lymphocytic lymphoma 9670/3
T lymphoblastic leukemia/lymphoma 9670/3B
B Lymphoblastic leukemia/lymphoma with
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
t(5;14)(q31;q32); IL3-IGH 9817/3
Module Headings
Original Hematopoietic Rules
Comments
B lymphoblastic leukemia/lymphoma with
t(9;22)(q34;q11.2); BCR-ABL1 9812/3
B lymphoblastic leukemia/lymphomas, NOS 9811/3,
9812/3-9818/3
Blastic plasmacytoid dendritic cell neoplasm (Blastic
natural killer leukemia/lymphoma) 9727/3
Chronic lymphocytic leukemia/small lymphocytic
lymphoma (CLL/SLL) 9823/3
Lymphoblastic leukemia/lymphoma with t(v;11q23);
MLL rearranged 9813/3
Module 4: Preleukemia, Smoldering Leukemia, and
Myelodysplastic Syndrome PH11
Preleukemia, smoldering leukemia, and
myelodysplastic syndrome 9989/3
Module 5: Myeloid Neoplasms and Mast Cell
Neoplasms PH12 - PH15
Myeloid leukemias, 9840. 9861/3, 9865-9967, 9869,
9891, 9895-9898, 9910, 9911, 9931
Module 4: Preleukemia, Smoldering Leukemia, and
Myelodysplastic Syndrome PH11
Preleukemia, smoldering leukemia, and
myelodysplastic syndrome 9989/3
No changes
Module 5: Myeloid Neoplasms PH14-PH15
Acute myeloid leukemia, NOS 9861/3
Myeloid sarcoma 9930/3
Additional histologies (leukemias in range)
added in 2012. In 2013, range changed to
include only the myeloid neoplasms.
No changes 2014
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
Mast cell leukemia 9742/3
Mast cell sarcoma 9740/3
Myeloid sarcoma 9930/3
Module Headings
Original Hematopoietic Rules
Comments
Module 6: Coding Primary Site for Specified
Lymphomas PH16 - PH24
B-cell lymphoma, with features intermediate between
diffuse large B-cell lymphoma and classical Hodgkin
lymphoma 9596/3
Diffuse large B-cell lymphoma 9680/3
Follicular lymphoma 9690/3
Follicular lymphoma, grade 1 9695/3
Follicular lymphoma, grade 2 9691/3
Follicular lymphoma, grade 3, 3A, 3B 9698/3
Lymphoplasmacytic lymphoma 9671/3
Primary cutaneous follicle center cell lymphoma
9597/3
Waldenstrom macroglobulinemia 9761/3
Module 6: Coding Primary Site and Histology for
Specified Lymphoma PH16-PH24
Composite lymphoma 9596/3
Diffuse large B-cell lymphoma 9680/3
Follicle cell lymphoma 9597/3
Follicular lymphoma 9690/3
Follicular lymphoma, grade 1 9695/3
Follicular lymphoma, grade 2 9691/3
Follicular lymphoma, grade 3A, 3B 9698/3
Lymphoplasmacytic lymphoma 9671/3
Waldenstrom macroglobulinemia 9761/3
No changes
Module 7: Coding Primary Site for Lymphomas Only
PH25 - PH37
Module 7: Primary Site Rules for Lymphomas Only
9590/3-9729/3
PH25-PH37
Remaining lymphoma histologies added
Module 8: Histology Rules Only: All hematopoietic
and lymphoid neoplasms 9590/3-9992/3
Module 8 deleted from 2012 due to duplicate
rules
9590/3-9729/3, 9811/3-9818/3, 9823/3, 9827/3,
9837/3
Module 8 from 2012 deleted, duplicate rules PH38 and
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Hematopoietic and Lymphoid Neoplasm Manual Comparisons (2010, 2012, 2014)
Hematopoietic Rules for cases diagnosed 2010+
PH39, only rules in Module 8.
Module Headings
Original Hematopoietic Rules
PH38 - PH39
Comments
Module 9: Default Rules: All hematopoietic and
lymphoid neoplasms 9590/3-9992/3
PH40-PH41
Revised Module 8 for NOS histologies
(Revised) Module 9: Coding Primary Site and Histology
PH40 - PH41
Module 9: Coding Primary Site and Histology PH40 PH41
No changes from 2010. Module changed in
2012 due to duplicate rules
All hematopoietic and lymphoid neoplasms 9590/39992/3
All hematopoietic and lymphoid neoplasms 9590/39992/3
Use Only When Modules 1-8 are Not Applicable
Use Only When Modules 1-8 are Not Applicable
(Revised) Module 8: NOS and More Specific Histology
PH38 – PH39
All hematopoietic and lymphoid neoplasms 9590/39992/3
17