Page 1 of 42

Internal Dosimetry Organ, External 

Dosimetry Organ, and IREP Model Selection 

by ICD-10 Code

ORAUT-OTIB-0005 Rev. 06

Effective Date: 09/27/2019

Supersedes: Revision 05

Subject Expert(s): Scott R. Siebert

Document Owner 

Approval: Signature on File

Scott R. Siebert, Document Owner

Approval Date: 09/23/2019

Concurrence: Vickie S. Short Signature on File for

Kate Kimpan, Project Director

Concurrence Date: 09/24/2019

Approval: Signature on File

Timothy D. Taulbee, Associate Director for Science

Approval Date: 09/27/2019

FOR DOCUMENTS MARKED AS A TOTAL REWRITE, REVISION, OR PAGE CHANGE, REPLACE THE PRIOR 

REVISION AND DISCARD / DESTROY ALL COPIES OF THE PRIOR REVISION.

New Total Rewrite Revision Page Change
Document No. ORAUT-OTIB-0005 Revision No. 06 Effective Date: 09/27/2019 Page 2 of 42

 

PUBLICATION RECORD

EFFECTIVE

DATE

REVISION

NUMBER DESCRIPTION

11/03/2003 00 ORAU Team technical information bulletin to clarify IMBA organ and 

IREP model selection First approved issue. Initiated by Elizabeth M. 

Brackett.

01/23/2004 01 Incorporates applicable external dosimetry organ selection. 

Approved issue of Revision 01. Initiated by Elizabeth M. Brackett.

03/05/2004 01 PC-1 IREP model correction for ICD-9 code 238.7 (added Bone model), 

remove IMBA/External/IREP model info from header rows for ICD-9 

codes 194 and 205. Approved issue of page change 1. Initiated by 

Elizabeth M. Brackett.

05/07/2004 01 PC-2 IMBA and External model correction for ICD-9 code 231.8 (changed 

to med review on page 15), IMBA model correction for ICD-9 codes 

235.8 and 235.9 (changed to med review on page 16), External 

model correction for ICD-9 code 185 (changed to bladder on page 8). 

Approved issue of page change 2. Initiated by Elizabeth M. Brackett.

10/29/2004 01 PC-3 IMBA model correction for ICD-9 code 189.2, 189.3, and 189.4 

(changed to highest non-met organ/tissue on page 9), added 

footnote number 5 to Table 1 for ICD-9 code 232 on page 18. 

Changed DOL documentation to NIOSH Referral Summary 

Document (NRSD) on page 20. Approved issue of page change 3. 

Initiated by Scott R. Siebert.

12/02/2005 02 Adds information for ICD-9 codes 289.7 and 289.9, clarifies handling 

adenocarcinoma of the distal (lower third) esophagus, corrects 

external organ for ICD-9 codes 233.4 and 236.5, updates correct 

model selections for various cancers (to reflect guidance in OCASTIB-012, except as directed by OCAS to mark many 200-204 organs 

as “Reserved”), adds likely primary cancer selection for secondary 

cancers. Changes references to “IMBA organ” to “Internal Dosimetry 

organ.” Approved issue of Revision 02. Training required: As 

determined by the Task Manager. Initiated by Scott R. Siebert.

02/10/2006 02 PC-1 Approved page change revision. Updates Table 3-1 (pages 15 to 22) 

in Section 3.2 to reflect guidance in OCAS-TIB-012 Rev 1 (internal 

and external organs for ICD-9 series 200 through 204 changed from 

“Reserved” to the specified organ) and changes OCAS-TIB-012 

issue date and revision number in reference section (page 33). No 

sections were deleted. Training required: As determined by the 

Task Manager. Initiated by Scott R. Siebert. 

02/27/2010 03 Adds discussion of ICD-9 vs. ICD-9-CM in Background section, adds 

codes into Tables 3-1 and 3-2 that cross-reference to ICD-9-CM 

codes, adds clarification for skin cancer codes, updates organ 

selection for ICD-9 codes 155 and 156, adds clarification that this 

TIB is not applicable for x-ray procedures. No sections were deleted. 

Incorporates formal internal and NIOSH review comments. 

Constitutes a total rewrite of the document. Training required: As 

determined by the Objective Manager. Initiated by Scott R. Siebert.
Document No. ORAUT-OTIB-0005 Revision No. 06 Effective Date: 09/27/2019 Page 3 of 42

EFFECTIVE

DATE

REVISION

NUMBER DESCRIPTION

04/18/2011 04 Changes external organ for ICD-9 codes 194.1 and 194.5 to Thyroid 

only (rather than Thyroid/Remainder), adds BCC as an IREP model 

option for ICD-9 code 232, changes internal organ from Medical 

Review to Skin for 238.2, add SCC as an IREP model option for 

238.2, updates footnote “e” to include ICD-9 code 238.2 and BCC, 

update the internal organ from “Medical Review” to a specific organ 

of interest for 236.91 (Kidney), 238.0 (Bone surface), 238.3 (Breast), 

239.2 (Bone surface or Skin depending on cancer type). Additional 

change to 238.0 and 239.2 (bone) based on formal internal review 

comments – both changed to bone surface for internal and external 

organs. Additional change to add SCC as viable IREP model for 

239. 2(skin) based on formal NIOSH review. Training required: As 

determined by the Objective Manager. Initiated by Scott R. Siebert.

12/20/2012 05 Adds Chronic lymphocytic leukemia (CLL) as radiogenic cancer –

Section 4.11, Table 3-1 (ICD-9 code 204.1 series), footnote “d” to 

Table 3-1. Added clarification to Sec 4.9 on comparisons of ULI and 

LLI. Update Table 3-1 to add fifth digit in ICD-9 codes for 173, add 

clarification to Sec 4.7 for same. Update 150.1 and 150.9 to clarify 

that stomach is not appropriate for either code since location is either 

thoracic or unspecified and add discussion of “nec” and “nos” to Sec 

4.8. Added discussion of ICD-9 code 199 in Section 3.2. 

Incorporates formal internal and NIOSH review comments. Training 

required: As determined by the Objective Manager. Initiated by 

Scott R. Siebert.

09/27/2019 06 Revision initiated to transition from the ICD-9 code system to the 

ICD-10 code system. Incorporates internal and NIOSH review 

comments. Constitutes a total rewrite of the document. Training 

required: As determined by the Objective Manager. Initiated by 

Scott R. Siebert. 
Document No. ORAUT-OTIB-0005 Revision No. 06 Effective Date: 09/27/2019 Page 4 of 42

 

TABLE OF CONTENTS

SECTION TITLE PAGE

Acronyms and Abbreviations ............................................................................................................... 5

1.0 Introduction .............................................................................................................................. 6

1.1 Purpose........................................................................................................................ 6

1.2 Scope........................................................................................................................... 6

2.0 Background.............................................................................................................................. 6

3.0 Guidance ................................................................................................................................. 7

3.1 Selection of Appropriate Organs, Tissues, and Models................................................. 7

3.2 Secondary Cancers with Unknown Primary Cancer Site............................................... 7

3.3 Simplification of Table 3-1 ............................................................................................ 7

4.0 Discussion ............................................................................................................................. 36

4.1 Highest Nonmetabolic Organ...................................................................................... 36

4.2 Medical Review .......................................................................................................... 36

4.2.1 Medical Review for Appropriate Line in Table 3-1 ........................................ 36

4.3 Thyroid or Remainder Selection for External Dose ..................................................... 37

4.4 Remainder Selection for External Dose ...................................................................... 37

4.5 Bladder....................................................................................................................... 37

4.6 Multiple IREP Models ................................................................................................. 37

4.7 Skin Cancer Model Clarification.................................................................................. 38

4.8 Adenocarcinoma of the Distal (Lower Third) Esophagus ............................................ 38

4.9 Secondary Cancers – Likely Primary Cancer Sites with Multiple IMBA, External, 

and IREP Organ Model Options ................................................................................. 38

4.10 Multiple Secondary Cancers with Unknown Primary Cancer Site or Multiple 

Primary and Secondary Cancers ................................................................................ 39

4.11 Chronic Lymphocytic Leukemia.................................................................................. 40

4.12 Organ BB for Carcinoma in situ of Trachea ................................................................ 40

References ........................................................................................................................................ 41

LIST OF TABLES

TABLE TITLE PAGE

3-1 Selection of organs, tissues, and IREP models for internal and external dose 

reconstruction based on ICD-10 code ...................................................................................... 9

3-2 Selection of primary cancer(s) for dose reconstruction from secondary cancer codes............ 35
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ACRONYMS AND ABBREVIATIONS 

BB bronchial region

BCC basal cell carcinoma

CLL chronic lymphocytic leukemia

DOE U.S. Department of Energy

DOL U.S. Department of Labor

ET1 extrathoracic region 1

ET2 extrathoracic region 2

ICD-10 International Statistical Classification of Diseases and Related Health Problems, 10th 

Revision

ICD-10-CM The International Classification of Diseases, Tenth Revision, Clinical Modification

ICRP International Commission on Radiological Protection

IMBA Integrated Modules for Bioassay Analysis

IREP Interactive RadioEpidemiological Program

LLI lower large intestine

LN(ET) extrathoracic lymph nodes

LN(TH) thoracic lymph nodes

NEC not elsewhere classified

NIOSH National Institute for Occupational Safety and Health

NOS not otherwise specified

NRSD NIOSH Referral Summary Document

OCAS Office of Compensation Analysis and Support

ORAU Oak Ridge Associated Universities

POC probability of causation

SCC squamous cell carcinoma

SI small intestine

SRDB Ref ID Site Research Database Reference Identification (number)

TIB technical information bulletin

ULI upper large intestine

U.S.C. United States Code

§ section or sections
Document No. ORAUT-OTIB-0005 Revision No. 06 Effective Date: 09/27/2019 Page 6 of 42

1.0 INTRODUCTION

Technical information bulletins (TIBs) are not official determinations made by the National Institute for 

Occupational Safety and Health (NIOSH) but are rather general working documents that provide 

historical background information and guidance to assist in the preparation of dose reconstructions at 

particular sites or categories of sites. They will be revised in the event additional relevant information 

is obtained about the affected site(s). TIBs may be used to assist NIOSH staff in the completion of 

individual dose reconstructions.

In this document, the word “facility” is used as a general term for an area, building, or group of 

buildings that served a specific purpose at a site. It does not necessarily connote an “atomic weapons 

employer facility” or a “Department of Energy (DOE) facility” as defined in the Energy Employees 

Occupational Illness Compensation Program Act of 2000 [42 U.S.C. § 7384l(5) and (12)].

1.1 PURPOSE

This TIB provides guidance on selection of (1) the appropriate International Commission on 

Radiological Protection (ICRP) organ or tissue model to estimate the internal dose for specific codes 

based on the World Health Organization’s International Statistical Classification of Diseases and 

Related Health Problems, 10th Revision (ICD-10; WHO 2016), (2) the appropriate ICRP organs or 

tissues to estimate external dose, and (3) the appropriate model in the Interactive 

RadioEpidemiological Program (IREP). This TIB also provides information for selecting and 

assessing likely primary cancers for secondary cancers.

1.2 SCOPE

This TIB does not address the appropriate ICRP organ to use with medical X-ray procedures due to 

different potential exposure geometries of those procedures. This information can be found in 

ORAUT-OTIB-0006, Dose Reconstruction from Occupational Medical X-Ray Procedures (ORAUT 

2019d).

2.0 BACKGROUND

Under the Energy Employees Occupational Illness Compensation Program Act of 2000, the organs or 

tissues for which doses must be estimated are those that are delineated by the specified ICD-10 code 

that is received from the U.S. Department of Labor (DOL). While many ICD-10 codes are clear in 

their intended organ or tissue, additional guidance is necessary to identify the appropriate organs or 

tissues for internal and external dose estimation and the IREP model to use for the organ or tissue. 

This TIB designates the appropriate internal dosimetry organ and tissue selection for the various 

ICD-10 coded cancers, the appropriate organs and tissues to estimate external dose, and the 

appropriate IREP model.

Coding of the cancers is conducted by DOL on the basis of ICD-10. The U.S. Department of Health 

and Human Services National Center for Health Statistics has issued a related document, 

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM; NCHS 

2018), which is widely used in the United States. ICD-10-CM is revised on an annual basis.

To facilitate consistency between the previous information under ICD-9 and the newer codes under 

ICD-10, a comparison of them was conducted in ORAUT-RPRT-0098, Rationale for Matching ICD-9 

Codes to ICD-10 Codes for Predetermined Organ and IREP Model Selections (ORAUT 2019a). That

report and the information in two supporting spreadsheets (ORAUT 2019b, 2019c) were used to 

create the information in the tables in this document.
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3.0 GUIDANCE

3.1 SELECTION OF APPROPRIATE ORGANS, TISSUES, AND MODELS

Table 3-1 correlates ICD-10 codes to the appropriate organ and tissue selection for internal and 

external dose estimation and to the appropriate IREP model. Organs and tissues that are labeled 

“Highest non-met org/tiss” indicate that dose to the highest nonmetabolic organ is to be used to 

represent the dose to the designated ICD-10 organ or tissue. A discussion of this term is included in 

Section 4.1. The remaining regions correspond to the term in the Integrated Modules for Bioassay 

Analysis (IMBA) software program.

3.2 SECONDARY CANCERS WITH UNKNOWN PRIMARY CANCER SITE

Another situation that needs to be assessed is the diagnosis of a secondary cancer with an unknown 

primary cancer location. In its technical documentation of guidance of the use of IREP, NIOSH states 

(NIOSH 2002a, pp. 39,40): 

It is accepted in medicine that cancer-causing agents such as ionizing radiation produce 

primary cancers. This means, for a case in which the primary site of cancer is unknown, 

the primary site must be established by inference to estimate probability of causation. 

For each secondary cancer, the set of primary cancers producing approximately 75% of that 

secondary cancer among the U.S. population was identified (males and females were 

considered separately; Table 7). Therefore, for secondary cancers with unknown primary site, 

this table will be consulted to select likely primary sites, which will each then be evaluated 

using NIOSH-IREP.

Therefore, for secondary cancers with unknown primary sites, Table 3-2 should be consulted to select 

likely primary sites, which should then be evaluated using IREP. Because each secondary cancer in 

Table 3-2 has more than one likely primary cancer site, each likely primary site must be evaluated 

using IREP to determine a POC. If one of the likely primary cancer sites yields a POC greater than or 

equal to 50%, this site should be assumed to be the originating site for the secondary cancer and 

should be submitted as such.

If none of the likely primary cancer sites yields a POC greater than or equal to 50%, the supporting 

documentation for all of them should be submitted, demonstrating that all were less than 50%.

ICD-10 codes C45.9, C7B.00, C7B.09, C7B.8, C80.0, and C80.1 present unusual cases because they 

can be coded by DOL as either a primary or a secondary cancer. In either case, the location is either 

unknown or not clearly defined. If coded as a secondary cancer, this means both the secondary 

cancer as well as the primary cancer that caused it are unknown. Because this information is 

unknown, these codes should be assessed as outlined in Table 3-1 regardless of information on likely 

primary locations provided by DOL in the referral files.

3.3 SIMPLIFICATION OF TABLE 3-1

To conserve space in this document, a simplification to Table 3-1 has been made when all subcodes 

of any specific code have the same internal organ, external organ, and IREP model(s) defined for 

those codes. In such cases, the subcodes have been collapsed to the single higher code in the table 

and the listed organs and models are to be used for that code and all subcodes with additional 

extensions.
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For example, ICD-10 code C00 (Malignant neoplasm of lip) has multiple subcodes where the 

extensions define the specific location of the neoplasm on the lip. All of the locations given use the 

same internal organ (Highest non-met org/tiss), external organ (Skin), and IREP model (Oral cav and 

pharynx), so the codes have all been collapsed into code C00 in Table 3-1 and all subcodes will use 

this information for assessment. A listing of all codes and the ones that are collapsed are given in the 

supporting spreadsheet (ORAUT 2019c).
 

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Table 3-1. Selection of organs, tissues, and IREP models for internal and external dose reconstruction based on ICD-10 code. 

ICD-10

code Cancer code explanation Internal organ External organ IREP model

C00 Malignant neoplasm of lip Highest non-met org/tiss Skin Oral cav and pharynx

C01 Malignant neoplasm of base of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.0 Malignant neoplasm of dorsal surface of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.1 Malignant neoplasm of border of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.2 Malignant neoplasm of ventral surface of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.3 Malignant neoplasm of anterior two-thirds of 

tongue, part unspecified

Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.4 Malignant neoplasm of lingual tonsil LN(ET) Thyroid/remaindera Oral cav and pharynx

C02.8 Malignant neoplasm of overlapping sites of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C02.9 Malignant neoplasm of tongue, unspecified Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C03 Malignant neoplasm of gum Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C04 Malignant neoplasm of floor of mouth Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C05 Malignant neoplasm of palate/uvula Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C06 Malignant neoplasm of mouth Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C07 Malignant neoplasm of parotid gland Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C08 Malignant neoplasm of salivary gland Highest non-met org/tiss Thyroid/remaindera Oral cav and pharynx

C09 Malignant neoplasm of tonsil LN(ET) Esophagus Oral cav and pharynx

C10 Malignant neoplasm of oropharynx ET2 Esophagus Oral cav and pharynx

C11 Malignant neoplasm of nasopharynx ET2 Esophagus Oral cav and pharynx

C12 Malignant neoplasm of pyriform sinus ET2 Esophagus Oral cav and pharynx

C13 Malignant neoplasm of hypopharynx ET2 Esophagus Oral cav and pharynx

C14.0 Malignant neoplasm of pharynx, unspecified ET2 Esophagus Oral cav and pharynx

C14.2 Malignant neoplasm of Waldeyer's ring LN(ET) Esophagus Oral cav and pharynx

C14.8 Malignant neoplasm of overlapping sites of lip, 

oral cavity and pharynx

ET2 Esophagus Oral cav and pharynx

C15.3 Malignant neoplasm of upper third of esophagus Esophagus Esophagus Esophagus

C15.4 Malignant neoplasm of middle third of esophagus Esophagus Esophagus Esophagus

C15.5 Malignant neoplasm of lower third of esophagus Esophagus/stomachb Esophagus/stomachb Esophagus/stomachb

C15.8 Malignant neoplasm of overlapping sites of 

esophagus

Esophagus/stomachb Esophagus/stomachb Esophagus/stomachb

C15.9 Malignant neoplasm of esophagus, unspecified Esophagus Esophagus Esophagus

C16 Malignant neoplasm of stomach Stomach Stomach Stomach

C17 Malignant neoplasm of small intestine/Meckel's 

diverticulum

SI Stomach All digestive

C18.0 Malignant neoplasm of cecum ULI Colon Colon

C18.1 Malignant neoplasm of appendix ULI Colon Colon

C18.2 Malignant neoplasm of ascending colon ULI Colon Colon

C18.3 Malignant neoplasm of hepatic flexure ULI Colon Colon
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C18.4 Malignant neoplasm of transverse colon ULI Colon Colon

C18.5 Malignant neoplasm of splenic flexure LLI Colon Colon

C18.6 Malignant neoplasm of descending colon LLI Colon Colon

C18.7 Malignant neoplasm of sigmoid colon LLI Colon Colon

C18.8 Malignant neoplasm of overlapping sites of colon Colon Colon Colon

C18.9 Malignant neoplasm of colon, unspecified Colon Colon Colon

C19 Malignant neoplasm of rectosigmoid junction LLI Colon Rectum

C20 Malignant neoplasm of rectum LLI Colon Rectum

C21 Malignant neoplasm of rectum, anus, and anal 

cavity

LLI Colon Rectum

C22.0 Liver cell carcinoma Liver Liver Liver

C22.1 Intrahepatic bile duct carcinoma Liver/gallbladderc Liver Gallbladder

C22.2 Hepatoblastoma Liver Liver Liver

C22.3 Angiosarcoma of liver Liver Liver Liver

C22.4 Other sarcomas of liver Liver Liver Liver

C22.7 Other specified carcinomas of liver Liver Liver Liver

C22.8 Malignant neoplasm of liver, primary, unspecified 

as to type

Liver Liver Liver

C22.9 Malignant neoplasm of liver, not specified as 

primary or secondary

Liver Liver Liver

C23 Malignant neoplasm of gallbladder Gallbladder Liver Gallbladder

C24 Malignant neoplasm of biliary tract Gallbladder Liver Gallbladder

C25 Malignant neoplasm of pancreas Pancreas Stomach Pancreas

C26.0 Malignant neoplasm of intestinal tract, part 

unspecified

Colon Stomach All digestive

C26.1 Malignant neoplasm of spleen Spleen Stomach All digestive

C26.9 Malignant neoplasm of ill-defined sites within the 

digestive system

Highest non-met org/tiss Stomach All digestive

C30.0 Malignant neoplasm of nasal cavity ET1 Thyroid/remaindera Other respiratory

C30.1 Malignant neoplasm of middle ear Highest non-met org/tiss Thyroid/remaindera Other respiratory

C31 Malignant neoplasm of sinus Highest non-met org/tiss Thyroid/remaindera Other respiratory

C32 Malignant neoplasm of larynx ET2 Esophagus Other respiratory

C33 Malignant neoplasm of trachea Lung Lung Lung

C34 Malignant neoplasm of bronchus/lung Lung Lung Lung

C37 Malignant neoplasm of thymus Thymus Thymus Other respiratory

C38.0 Malignant neoplasm of heart Heart Wall Thymus Other respiratory

C38.1 Malignant neoplasm of anterior mediastinum Highest non-met org/tiss Thymus Other respiratory

C38.2 Malignant neoplasm of posterior mediastinum Highest non-met org/tiss Thymus Other respiratory
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C38.3 Malignant neoplasm of mediastinum, part 

unspecified

Highest non-met org/tiss Thymus Other respiratory

C38.4 Malignant neoplasm of pleura Highest non-met org/tiss Lung Other respiratory

C38.8 Malignant neoplasm of overlapping sites of heart, 

mediastinum and pleura

Highest non-met org/tiss Thymus Other respiratory

C39 Malignant neoplasm of upper/lower respiratory 

tract, part unspecified

Lung Lung Other respiratory

C40.00 Malignant neoplasm of scapula and long bones of 

unspecified upper limb

Bone surface Bone surface Bone

C40.01 Malignant neoplasm of scapula and long bones of 

right upper limb

Bone surface Bone surface Bone

C40.02 Malignant neoplasm of scapula and long bones of 

left upper limb

Bone surface Bone surface Bone

C40.10 Malignant neoplasm of short bones of unspecified 

upper limb

Bone surface Bone surface Bone

C40.11 Malignant neoplasm of short bones of right upper 

limb

Bone surface Bone surface Bone

C40.12 Malignant neoplasm of short bones of left upper 

limb

Bone surface Bone surface Bone

C40.20 Malignant neoplasm of long bones of unspecified 

lower limb

Medical review Bone surface Bone

C40.21 Malignant neoplasm of long bones of right lower 

limb

Medical review Bone surface Bone

C40.22 Malignant neoplasm of long bones of left lower 

limb

Medical review Bone surface Bone

C40.30 Malignant neoplasm of short bones of unspecified 

lower limb

Bone surface Bone surface Bone

C40.31 Malignant neoplasm of short bones of right lower 

limb

Bone surface Bone surface Bone

C40.32 Malignant neoplasm of short bones of left lower 

limb

Bone surface Bone surface Bone

C40.80 Malignant neoplasm of overlapping sites of bone 

and articular cartilage of unspecified limb

Medical review Bone surface Bone

C40.81 Malignant neoplasm of overlapping sites of bone 

and articular cartilage of right limb

Medical review Bone surface Bone

C40.82 Malignant neoplasm of overlapping sites of bone 

and articular cartilage of left limb

Medical review Bone surface Bone

C40.90 Malignant neoplasm of unspecified bones and

articular cartilage of unspecified limb

Medical review Bone surface Bone
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C40.91 Malignant neoplasm of unspecified bones and 

articular cartilage of right limb

Medical review Bone surface Bone

C40.92 Malignant neoplasm of unspecified bones and 

articular cartilage of left limb

Medical review Bone surface Bone

C41.0 Malignant neoplasm of bones of skull and face Bone surface Bone surface Bone

C41.1 Malignant neoplasm of mandible Bone surface Bone surface Bone

C41.2 Malignant neoplasm of vertebral column Bone surface Bone surface Bone

C41.3 Malignant neoplasm of ribs, sternum and clavicle Medical review Bone surface Bone

C41.4 Malignant neoplasm of pelvic bones, sacrum and 

coccyx

Medical review Bone surface Bone

C41.9 Malignant neoplasm of bone and articular 

cartilage, unspecified

Medical review Bone surface Bone

C43 Malignant melanoma Skin Skin Malignant melanoma

C44.00 Unspecified malignant neoplasm of skin of lip Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.01 Basal cell carcinoma of skin of lip Skin Skin Non-melanoma skin-basal cell

C44.02 Squamous cell carcinoma of skin of lip Skin Skin Non-melanoma skin-squamous

C44.09 Other specified malignant neoplasm of skin of lip Skin Skin Non-melanoma skin-squamous celld

C44.10 Unspecified malignant neoplasm of skin of eyelid, 

including canthus

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.11 Basal cell carcinoma of skin of eyelid, including 

canthus

Skin Skin Non-melanoma skin-basal cell

C44.12 Squamous cell carcinoma of skin of eyelid, 

including canthus

Skin Skin Non-melanoma skin-squamous

C44.19 Other specified malignant neoplasm of skin of 

eyelid, including canthus

Skin Skin Non-melanoma skin-squamous celld

C44.20 Unspecified malignant neoplasm of skin of ear 

and external auricular canal

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.21 Basal cell carcinoma of skin of ear and external 

auricular canal

Skin Skin Non-melanoma skin-basal cell

C44.22 Squamous cell carcinoma of skin of ear and 

external auricular canal

Skin Skin Non-melanoma skin-squamous

C44.29 Other specified malignant neoplasm of skin of ear 

and external auricular canal

Skin Skin Non-melanoma skin-squamous celld

C44.30 Unspecified malignant neoplasm of skin of 

nose/face

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.31 Basal cell carcinoma of skin of nose/face Skin Skin Non-melanoma skin-basal cell

C44.32 Squamous cell carcinoma of skin of nose/face Skin Skin Non-melanoma skin-squamous

C44.39 Other specified malignant neoplasm of skin of 

nose/face

Skin Skin Non-melanoma skin-squamous celld
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C44.40 Unspecified malignant neoplasm of skin of scalp 

and neck

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.41 Basal cell carcinoma of skin of scalp and neck Skin Skin Non-melanoma skin-basal cell

C44.42 Squamous cell carcinoma of skin of scalp and 

neck

Skin Skin Non-melanoma skin-squamous

C44.49 Other specified malignant neoplasm of skin of 

scalp and neck

Skin Skin Non-melanoma skin-squamous celld

C44.50 Unspecified malignant neoplasm of 

anal/breast/trunk skin

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.51 Basal cell carcinoma of anal/breast/trunk skin Skin Skin Non-melanoma skin-basal cell

C44.52 Squamous cell carcinoma of anal/breast/trunk 

skin

Skin Skin Non-melanoma skin-squamous

C44.59 Other specified malignant neoplasm of 

anal/breast/trunk skin

Skin Skin Non-melanoma skin-squamous celld

C44.60 Unspecified malignant neoplasm of skin of upper 

limb, including shoulder

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.61 Basal cell carcinoma of skin of upper limb, 

including shoulder

Skin Skin Non-melanoma skin-basal cell

C44.62 Squamous cell carcinoma of skin of upper limb, 

including shoulder

Skin Skin Non-melanoma skin-squamous

C44.69 Other specified malignant neoplasm of skin of 

upper limb, including shoulder

Skin Skin Non-melanoma skin-squamous celld

C44.70 Unspecified malignant neoplasm of skin of lower 

limb, including hip

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.71 Basal cell carcinoma of skin of lower limb, 

including hip

Skin Skin Non-melanoma skin-basal cell

C44.72 Squamous cell carcinoma of skin of lower limb, 

including hip

Skin Skin Non-melanoma skin-squamous

C44.79 Other specified malignant neoplasm of skin of 

lower limb, including hip

Skin Skin Non-melanoma skin-squamous celld

C44.80 Unspecified malignant neoplasm of overlapping 

sites of skin

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.81 Basal cell carcinoma of overlapping sites of skin Skin Skin Non-melanoma skin-basal cell

C44.82 Squamous cell carcinoma of overlapping sites of 

skin

Skin Skin Non-melanoma skin-squamous

C44.89 Other specified malignant neoplasm of 

overlapping sites of skin

Skin Skin Non-melanoma skin-squamous celld

C44.90 Unspecified malignant neoplasm of skin, 

unspecified

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

C44.91 Basal cell carcinoma of skin, unspecified Skin Skin Non-melanoma skin-basal cell
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C44.92 Squamous cell carcinoma of skin, unspecified Skin Skin Non-melanoma skin-squamous

C44.99 Other specified malignant neoplasm of skin, 

unspecified

Skin Skin Non-melanoma skin-squamous celld

C45.0 Mesothelioma of pleura Highest non-met org/tiss Lung Other respiratory

C45.1 Mesothelioma of peritoneum Highest non-met org/tiss Stomach All digestive

C45.2 Mesothelioma of pericardium Heart Wall Thymus Other respiratory

C45.7 Mesothelioma of other sites Highest non-met org/tiss Remaindere Other and ill-defined sites

C45.9f Mesothelioma, unspecified Highest non-met org/tiss Remaindere Other and ill-defined sites

C46.0 Kaposi's sarcoma of skin Skin Skin Connective tissue and

Non-melanoma skin-squamous cell

C46.1 Kaposi's sarcoma of soft tissue Highest non-met org/tiss Remaindere Connective tissue and

Non-melanoma skin-squamous cell

C46.2 Kaposi's sarcoma of palate Highest non-met org/tiss Thyroid/remaindera Connective tissue and

Non-melanoma skin-squamous cell

C46.3 Kaposi's sarcoma of lymph nodes Highest non-met org/tiss Remaindere Connective tissue and

Non-melanoma skin-squamous cell

C46.4 Kaposi's sarcoma of gastrointestinal sites Colon Stomach/colon 

(location dependent)

Connective tissue and

Non-melanoma skin-squamous cell

C46.5 Kaposi's sarcoma of lung Lung Lung Connective tissue and

Non-melanoma skin-squamous cell

C46.7 Kaposi's sarcoma of other sites Highest non-met org/tiss Remaindere Connective tissue and

Non-melanoma skin-squamous cell

C46.9 Kaposi's sarcoma, unspecified Highest non-met org/tiss Remaindere Connective tissue and

Non-melanoma skin-squamous cell

C47.0 Malignant neoplasm of peripheral nerves of head, 

face and neck

Highest non-met org/tiss Thyroid/remaindera Connective tissue

C47.1 Malignant neoplasm of peripheral nerves of upper 

limb, including shoulder

Highest non-met org/tiss Remaindere Connective tissue

C47.2 Malignant neoplasm of peripheral nerves of lower 

limb, including hip

Highest non-met org/tiss Remaindere Connective tissue

C47.3 Malignant neoplasm of peripheral nerves of thorax Highest non-met org/tiss Remaindere Connective tissue

C47.4 Malignant neoplasm of peripheral nerves of 

abdomen

Highest non-met org/tiss Remaindere Connective tissue

C47.5 Malignant neoplasm of peripheral nerves of pelvis Highest non-met org/tiss Remaindere Connective tissue

C47.6 Malignant neoplasm of peripheral nerves of trunk, 

unspecified

Highest non-met org/tiss Remaindere Connective tissue

C47.8 Malignant neoplasm of overlapping sites of 

peripheral nerves and autonomic nervous system

Highest non-met org/tiss Remaindere Connective tissue

C47.9 Malignant neoplasm of peripheral nerves and 

autonomic nervous system, unspecified

Highest non-met org/tiss Remaindere Connective tissue
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C48 Malignant neoplasm of 

retroperitoneum/peritoneum

Highest non-met org/tiss Stomach All digestive

C49.0 Malignant neoplasm of connective and soft tissue 

of head, face and neck

Highest non-met org/tiss Thyroid/remaindera Connective tissue

C49.1 Malignant neoplasm of connective and soft tissue 

of upper limb, including shoulder

Highest non-met org/tiss Remaindere Connective tissue

C49.2 Malignant neoplasm of connective and soft tissue 

of lower limb, including hip

Highest non-met org/tiss Remaindere Connective tissue

C49.3 Malignant neoplasm of connective and soft tissue 

of thorax

Highest non-met org/tiss Remaindere Connective tissue

C49.4 Malignant neoplasm of connective and soft tissue 

of abdomen

Highest non-met org/tiss Remaindere Connective tissue

C49.5 Malignant neoplasm of connective and soft tissue 

of pelvis

Highest non-met org/tiss Remaindere Connective tissue

C49.6 Malignant neoplasm of connective and soft tissue 

of trunk, unspecified

Highest non-met org/tiss Remaindere Connective tissue

C49.8 Malignant neoplasm of overlapping sites of 

connective and soft tissue

Highest non-met org/tiss Remaindere Connective tissue

C49.9 Malignant neoplasm of connective and soft tissue, 

unspecified

Highest non-met org/tiss Remaindere Connective tissue

C49.A Gastrointestinal stromal tumor Highest non-met org/tiss Remaindere Connective tissue

C4A Merkel cell carcinoma Skin Skin Non-melanoma skin-squamous cell

C50 Malignant neoplasm of breast Breast Breast Breast

C51.0 Malignant neoplasm of labium majus Skin Uterus Female genitalia less ovary

C51.1 Malignant neoplasm of labium minus Skin Uterus Female genitalia less ovary

C51.2 Malignant neoplasm of clitoris Skin Uterus Female genitalia less ovary

C51.8 Malignant neoplasm of overlapping sites of vulva Uterus Uterus Female genitalia less ovary

C51.9 Malignant neoplasm of vulva, unspecified Skin Uterus Female genitalia less ovary

C52 Malignant neoplasm of vagina Muscle Uterus Female genitalia less ovary

C53 Malignant neoplasm of cervix Uterus Uterus Female genitalia less ovary

C54 Malignant neoplasm of corpus uteri Uterus Uterus Female genitalia less ovary

C55 Malignant neoplasm of uterus, part unspecified Uterus Uterus Female genitalia less ovary

C56 Malignant neoplasm of ovary Ovaries Ovaries Ovary

C57.0 Malignant neoplasm of fallopian tube Ovaries Ovaries Ovary

C57.1 Malignant neoplasm of broad ligament Ovaries Ovaries Ovary

C57.2 Malignant neoplasm of round ligament Uterus Ovaries Ovary

C57.3 Malignant neoplasm of parametrium Uterus Ovaries Ovary

C57.4 Malignant neoplasm of uterine adnexa, 

unspecified

Ovaries Ovaries Ovary
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C57.7 Malignant neoplasm of other specified female 

genital organs

Uterus Uterus Female genitalia less ovary

C57.8 Malignant neoplasm of overlapping sites of female 

genital organs

Uterus Uterus Female genitalia less ovary

C57.9 Malignant neoplasm of female genital organ, 

unspecified

Uterus Uterus Female genitalia less ovary

C58 Malignant neoplasm of placenta Uterus Uterus Female genitalia less ovary

C60.0 Malignant neoplasm of prepuce Skin Testes All male genitalia

C60.1 Malignant neoplasm of glans penis Skin Testes All male genitalia

C60.2 Malignant neoplasm of body of penis Testes Testes All male genitalia

C60.8 Malignant neoplasm of overlapping sites of penis Testes Testes All male genitalia

C60.9 Malignant neoplasm of penis, unspecified Testes Testes All male genitalia

C61 Malignant neoplasm of prostate Highest non-met org/tiss Bladder All male genitalia

C62 Malignant neoplasm of testis Testes Testes All male genitalia

C63 Malignant neoplasm of other and unspecified 

male genital organs

Testes Testes All male genitalia

C64 Malignant neoplasm of kidney, except renal pelvis Kidney Liver Urinary organs less bladder

C65 Malignant neoplasm of renal pelvis Kidney Liver Urinary organs less bladder

C66 Malignant neoplasm of ureter Highest non-met org/tiss Liver Urinary organs less bladder

C67 Malignant neoplasm of bladder Bladder Bladder Bladder

C68.0 Malignant neoplasm of urethra Highest non-met org/tiss Liver Urinary organs less bladder

C68.1 Malignant neoplasm of paraurethral glands Highest non-met org/tiss Liver Urinary organs less bladder

C68.8 Malignant neoplasm of overlapping sites of urinary 

organs

Bladder Liver Urinary organs less bladder

C68.9 Malignant neoplasm of urinary organ, unspecified Medical review Liver Urinary organs less bladder

C69.0 Malignant neoplasm of conjunctiva Skin Eye lens Eye

C69.1 Malignant neoplasm of cornea Skin Eye lens Eye

C69.2 Malignant neoplasm of retina Brain Eye lens Eye

C69.3 Malignant neoplasm of choroid Brain Eye lens Eye

C69.4 Malignant neoplasm of ciliary body Brain Eye lens Eye

C69.5 Malignant neoplasm of lacrimal gland and duct Skin Eye lens Eye

C69.6 Malignant neoplasm of orbit Brain Eye lens Eye

C69.8 Malignant neoplasm of overlapping sites of eye 

and adnexa

Skin Eye lens Eye

C69.9 Malignant neoplasm of unspecified site of eye Skin Eye lens Eye

C70 Malignant neoplasm of meninges Brain Thyroid/remaindera Nervous system

C71 Malignant neoplasm of brain Brain Thyroid/remaindera Nervous system

C72 Malignant neoplasm of spinal cord, cranial nerves, 

and other parts of Cent Nerv Sys

Brain Thyroid/remaindera Nervous system

C73 Malignant neoplasm of thyroid gland Thyroid Thyroid Thyroid
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C74 Malignant neoplasm of adrenal gland Adrenals Thyroid/remaindera Other endocrine glands

C75.0 Malignant neoplasm of parathyroid gland Thyroid Thyroid Other endocrine glands

C75.1 Malignant neoplasm of pituitary gland Brain Thyroid/remaindera Other endocrine glands

C75.2 Malignant neoplasm of craniopharyngeal duct Brain Thyroid/remaindera Other endocrine glands

C75.3 Malignant neoplasm of pineal gland Brain Thyroid/remaindera Other endocrine glands

C75.4 Malignant neoplasm of carotid body Brain Thyroid Other endocrine glands

C75.5 Malignant neoplasm of aortic body and other 

paraganglia

Brain Thyroid/remaindera Other endocrine glands

C75.8 Malignant neoplasm with pluriglandular 

involvement, unspecified

Medical review Remaindere Other endocrine glands

C75.9 Malignant neoplasm of endocrine gland, 

unspecified

Medical review Remaindere Other endocrine glands

C76.0 Malignant neoplasm of head, face and neck Highest non-met org/tiss Thyroid/remaindera Other and ill-defined sites

C76.1 Malignant neoplasm of thorax Highest non-met org/tiss Remaindere Other and ill-defined sites

C76.2 Malignant neoplasm of abdomen Highest non-met org/tiss Remaindere Other and ill-defined sites

C76.3 Malignant neoplasm of pelvis Highest non-met org/tiss Remaindere Other and ill-defined sites

C76.4 Malignant neoplasm of upper limb Highest non-met org/tiss Remaindere Other and ill-defined sites

C76.5 Malignant neoplasm of lower limb Highest non-met org/tiss Remaindere Other and ill-defined sites

C76.8 Malignant neoplasm of other specified ill-defined 

sites

Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.00 Malignant carcinoid tumor of unspecified site Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.01 Malignant carcinoid tumor of the small intestine SI Stomach All digestive

C7A.020 Malignant carcinoid tumor of the appendix ULI Colon Colon

C7A.021 Malignant carcinoid tumor of the cecum ULI Colon Colon

C7A.022 Malignant carcinoid tumor of the ascending colon ULI Colon Colon

C7A.023 Malignant carcinoid tumor of the transverse colon ULI Colon Colon

C7A.024 Malignant carcinoid tumor of the descending colon LLI Colon Colon

C7A.025 Malignant carcinoid tumor of the sigmoid colon LLI Colon Colon

C7A.026 Malignant carcinoid tumor of the rectum LLI Colon Rectum

C7A.029 Malignant carcinoid tumor of the large intestine, 

unspecified portion

Colon Colon Colon

C7A.090 Malignant carcinoid tumor of the bronchus and 

lung

Lung Lung Lung

C7A.091 Malignant carcinoid tumor of the thymus Thymus Thymus Other respiratory

C7A.092 Malignant carcinoid tumor of the stomach Stomach Stomach Stomach

C7A.093 Malignant carcinoid tumor of the kidney Kidney Liver Urinary organs less bladder

C7A.094 Malignant carcinoid tumor of the foregut, 

unspecified

Highest non-met org/tiss Remaindere Other and ill-defined sites
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C7A.095 Malignant carcinoid tumor of the midgut, 

unspecified

Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.096 Malignant carcinoid tumor of the hindgut, 

unspecified

Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.098 Malignant carcinoid tumors of other sites Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.1 Malignant poorly differentiated neuroendocrine 

tumors

Highest non-met org/tiss Remaindere Other and ill-defined sites

C7A.8 Other malignant neuroendocrine tumors Highest non-met org/tiss Remaindere Other and ill-defined sites

C7B.00f Secondary carcinoid tumors, unspecified site Highest non-met org/tiss Remaindere Other and ill-defined sites

C7B.09f Secondary carcinoid tumors of other sites Highest non-met org/tiss Remaindere Other and ill-defined sites

C7B.8f Other secondary neuroendocrine tumors Highest non-met org/tiss Remaindere Other and ill-defined sites

C80.0f Disseminated malignant neoplasm, unspecified Highest non-met org/tiss Remaindere Other and ill-defined sites

C80.1f Malignant (primary) neoplasm, unspecified Highest non-met org/tiss Remaindere Other and ill-defined sites

C81.00 Nodular lymphocyte predominant Hodgkin 

lymphoma, unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.01 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.02 Nodular lymphocyte predominant Hodgkin 

lymphoma, intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.03 Nodular lymphocyte predominant Hodgkin 

lymphoma, intra-abdominal lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.04 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.05 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of inguinal region and 

lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.06 Nodular lymphocyte predominant Hodgkin 

lymphoma, intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.07 Nodular lymphocyte predominant Hodgkin 

lymphoma, spleen

Spleen Stomach Lymphoma and multiple myeloma

C81.08 Nodular lymphocyte predominant Hodgkin 

lymphoma, lymph nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.09 Nodular lymphocyte predominant Hodgkin 

lymphoma, extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.10 Nodular sclerosis Hodgkin lymphoma, unspecified 

site

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.11 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.12 Nodular sclerosis Hodgkin lymphoma, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C81.13 Nodular sclerosis Hodgkin lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.14 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.15 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.16 Nodular sclerosis Hodgkin lymphoma, intrapelvic 

lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.17 Nodular sclerosis Hodgkin lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.18 Nodular sclerosis Hodgkin lymphoma, lymph 

nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.19 Nodular sclerosis Hodgkin lymphoma, extranodal 

and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.20 Mixed cellularity Hodgkin lymphoma, unspecified 

site

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.21 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.22 Mixed cellularity Hodgkin lymphoma, intrathoracic 

lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.23 Mixed cellularity Hodgkin lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.24 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.25 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.26 Mixed cellularity Hodgkin lymphoma, intrapelvic 

lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.27 Mixed cellularity Hodgkin lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.28 Mixed cellularity Hodgkin lymphoma, lymph nodes 

of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.29 Mixed cellularity Hodgkin lymphoma, extranodal 

and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.30 Lymphocyte depleted Hodgkin lymphoma, 

unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.31 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.32 Lymphocyte depleted Hodgkin lymphoma, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.33 Lymphocyte depleted Hodgkin lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C81.34 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.35 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.36 Lymphocyte depleted Hodgkin lymphoma, 

intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.37 Lymphocyte depleted Hodgkin lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.38 Lymphocyte depleted Hodgkin lymphoma, lymph 

nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.39 Lymphocyte depleted Hodgkin lymphoma,

extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.40 Lymphocyte-rich Hodgkin lymphoma, unspecified 

site

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.41 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.42 Lymphocyte-rich Hodgkin lymphoma, intrathoracic 

lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.43 Lymphocyte-rich Hodgkin lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.44 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.45 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.46 Lymphocyte-rich Hodgkin lymphoma, intrapelvic 

lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.47 Lymphocyte-rich Hodgkin lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.48 Lymphocyte-rich Hodgkin lymphoma, lymph 

nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.49 Lymphocyte-rich Hodgkin lymphoma, extranodal 

and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.70 Other Hodgkin lymphoma, unspecified site LN(TH) Thyroid Lymphoma and multiple myeloma

C81.71 Other Hodgkin lymphoma, lymph nodes of head, 

face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.72 Other Hodgkin lymphoma, intrathoracic lymph 

nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.73 Other Hodgkin lymphoma, intra-abdominal lymph 

nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.74 Other Hodgkin lymphoma, lymph nodes of axilla 

and upper limb

LN(TH) Lung Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C81.75 Other Hodgkin lymphoma, lymph nodes of 

inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.76 Other Hodgkin lymphoma, intrapelvic lymph 

nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.77 Other Hodgkin lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.78 Other Hodgkin lymphoma, lymph nodes of 

multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.79 Other Hodgkin lymphoma, extranodal and solid 

organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.90 Hodgkin lymphoma, unspecified, unspecified site LN(TH) Thyroid Lymphoma and multiple myeloma

C81.91 Hodgkin lymphoma, unspecified, lymph nodes of

head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C81.92 Hodgkin lymphoma, unspecified, intrathoracic 

lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C81.93 Hodgkin lymphoma, unspecified, intra-abdominal 

lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C81.94 Hodgkin lymphoma, unspecified, lymph nodes of 

axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C81.95 Hodgkin lymphoma, unspecified, lymph nodes of 

inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.96 Hodgkin lymphoma, unspecified, intrapelvic lymph 

nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C81.97 Hodgkin lymphoma, unspecified, spleen Spleen Stomach Lymphoma and multiple myeloma

C81.98 Hodgkin lymphoma, unspecified, lymph nodes of 

multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C81.99 Hodgkin lymphoma, unspecified, extranodal and 

solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C82 Follicular lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.00 Small cell B-cell lymphoma, unspecified site LN(TH) Thyroid Lymphoma and multiple myeloma

C83.01 Small cell B-cell lymphoma, lymph nodes of head, 

face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C83.02 Small cell B-cell lymphoma, intrathoracic lymph 

nodes

LN(TH) Lung Lymphoma and multiple myeloma

C83.03 Small cell B-cell lymphoma, intra-abdominal 

lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C83.04 Small cell B-cell lymphoma, lymph nodes of axilla 

and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C83.05 Small cell B-cell lymphoma, lymph nodes of 

inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C83.06 Small cell B-cell lymphoma, intrapelvic lymph 

nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.07 Small cell B-cell lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C83.08 Small cell B-cell lymphoma, lymph nodes of 

multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.09 Small cell B-cell lymphoma, extranodal and solid 

organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.10 Mantle cell lymphoma, unspecified site LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.11 Mantle cell lymphoma, lymph nodes of head, face, 

and neck

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.12 Mantle cell lymphoma, intrathoracic lymph nodes LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.13 Mantle cell lymphoma, intra-abdominal lymph 

nodes

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.14 Mantle cell lymphoma, lymph nodes of axilla and 

upper limb

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.15 Mantle cell lymphoma, lymph nodes of inguinal 

region and lower limb

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.16 Mantle cell lymphoma, intrapelvic lymph nodes LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.17 Mantle cell lymphoma, spleen LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.18 Mantle cell lymphoma, lymph nodes of multiple 

sites

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.19 Mantle cell lymphoma, extranodal and solid organ 

sites

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C83.30 Diffuse large B-cell lymphoma, unspecified site LN(TH) Thyroid Lymphoma and multiple myeloma

C83.31 Diffuse large B-cell lymphoma, lymph nodes of 

head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C83.32 Diffuse large B-cell lymphoma, intrathoracic lymph 

nodes

LN(TH) Lung Lymphoma and multiple myeloma

C83.33 Diffuse large B-cell lymphoma, intra-abdominal 

lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C83.34 Diffuse large B-cell lymphoma, lymph nodes of 

axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C83.35 Diffuse large B-cell lymphoma, lymph nodes of 

inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.36 Diffuse large B-cell lymphoma, intrapelvic lymph 

nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.37 Diffuse large B-cell lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C83.38 Diffuse large B-cell lymphoma, lymph nodes of 

multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C83.39 Diffuse large B-cell lymphoma, extranodal and 

solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.50 Lymphoblastic (diffuse) lymphoma, unspecified 

site

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.51 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C83.52 Lymphoblastic (diffuse) lymphoma, intrathoracic 

lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C83.53 Lymphoblastic (diffuse) lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma

C83.54 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C83.55 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.56 Lymphoblastic (diffuse) lymphoma, intrapelvic 

lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.57 Lymphoblastic (diffuse) lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C83.58 Lymphoblastic (diffuse) lymphoma, lymph nodes 

of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.59 Lymphoblastic (diffuse) lymphoma, extranodal 

and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.7 Burkitt lymphoma LN(TH) Lung Lymphoma and multiple myeloma

C83.80 Other non-follicular lymphoma, unspecified site LN(TH) Thyroid Lymphoma and multiple myeloma

C83.81 Other non-follicular lymphoma, lymph nodes of 

head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C83.82 Other non-follicular lymphoma, intrathoracic lymph 

nodes

LN(TH) Lung Lymphoma and multiple myeloma

C83.83 Other non-follicular lymphoma, intra-abdominal 

lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C83.84 Other non-follicular lymphoma, lymph nodes of 

axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C83.85 Other non-follicular lymphoma, lymph nodes of 

inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.86 Other non-follicular lymphoma, intrapelvic lymph 

nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.87 Other non-follicular lymphoma, spleen Spleen Stomach Lymphoma and multiple myeloma

C83.88 Other non-follicular lymphoma, lymph nodes of 

multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.89 Other non-follicular lymphoma, extranodal and 

solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C83.90 Non-follicular (diffuse) lymphoma, unspecified, 

unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.91 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C83.92 Non-follicular (diffuse) lymphoma, unspecified, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C83.93 Non-follicular (diffuse) lymphoma, unspecified, 

intra-abdominal lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C83.94 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C83.95 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.96 Non-follicular (diffuse) lymphoma, unspecified, 

intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C83.97 Non-follicular (diffuse) lymphoma, unspecified, 

spleen

Spleen Stomach Lymphoma and multiple myeloma

C83.98 Non-follicular (diffuse) lymphoma, unspecified, 

lymph nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C83.99 Non-follicular (diffuse) lymphoma, unspecified, 

extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.0 Mycosis fungoides Skin Skin Lymphoma and multiple myeloma

C84.1 Sezary disease Skin Skin Lymphoma and multiple myeloma

C84.4 Peripheral T-cell lymphoma, not classified Skin Skin Lymphoma and multiple myeloma

C84.60 Anaplastic large cell lymphoma, ALK-positive, 

unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.61 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C84.62 Anaplastic large cell lymphoma, ALK-positive, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C84.63 Anaplastic large cell lymphoma, ALK-positive, 

intra-abdominal lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C84.64 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C84.65 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C84.66 Anaplastic large cell lymphoma, ALK-positive, 

intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C84.67 Anaplastic large cell lymphoma, ALK-positive, 

spleen

Spleen Stomach Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C84.68 Anaplastic large cell lymphoma, ALK-positive, 

lymph nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.69 Anaplastic large cell lymphoma, ALK-positive, 

extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.70 Anaplastic large cell lymphoma, ALK-negative, 

unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.71 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C84.72 Anaplastic large cell lymphoma, ALK-negative, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C84.73 Anaplastic large cell lymphoma, ALK-negative, 

intra-abdominal lymph nodes

Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C84.74 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C84.75 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C84.76 Anaplastic large cell lymphoma, ALK-negative, 

intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C84.77 Anaplastic large cell lymphoma, ALK-negative, 

spleen

Spleen Stomach Lymphoma and multiple myeloma

C84.78 Anaplastic large cell lymphoma, ALK-negative, 

lymph nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.79 Anaplastic large cell lymphoma, ALK-negative, 

extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C84.9 Mature T/NK-cell lymphomas, unspecified LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C84.A Cutaneous T-cell lymphoma, unspecified Skin Skin Lymphoma and multiple myeloma

C84.Z Other mature T/NK-cell lymphomas LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C85.1 Unspecified B-cell lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C85.20 Mediastinal (thymic) large B-cell lymphoma, 

unspecified site

LN(TH) Thyroid Lymphoma and multiple myeloma

C85.21 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of head, face, and neck

LN(ET) Thyroid Lymphoma and multiple myeloma

C85.22 Mediastinal (thymic) large B-cell lymphoma, 

intrathoracic lymph nodes

LN(TH) Lung Lymphoma and multiple myeloma

C85.23 Mediastinal (thymic) large B-cell lymphoma, intraabdominal lymph nodesHighest non-met org/tiss Stomach Lymphoma and multiple myeloma

C85.24 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of axilla and upper limb

LN(TH) Lung Lymphoma and multiple myeloma

C85.25 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of inguinal region and lower limb

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C85.26 Mediastinal (thymic) large B-cell lymphoma, 

intrapelvic lymph nodes

Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C85.27 Mediastinal (thymic) large B-cell lymphoma, 

spleen

Spleen Stomach Lymphoma and multiple myeloma

C85.28 Mediastinal (thymic) large B-cell lymphoma, lymph 

nodes of multiple sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C85.29 Mediastinal (thymic) large B-cell lymphoma, 

extranodal and solid organ sites

LN(TH) Thyroid Lymphoma and multiple myeloma

C85.8 Other specified types of non-Hodgkin lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C85.9 Non-Hodgkin lymphoma, unspecified LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.0 Extranodal NK/T-cell lymphoma, nasal type LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.1 Hepatosplenic T-cell lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.2 Enteropathy-type (intestinal) T-cell lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.3 Subcutaneous panniculitis-like T-cell lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.4 Blastic NK-cell lymphoma LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C86.5 Angioimmunoblastic T-cell lymphoma LN(TH) Thyroid Lymphoma and multiple myeloma

C86.6 Primary cutaneous CD30-positive T-cell 

proliferations

Skin Skin Lymphoma and multiple myeloma

C88.0 Waldenstrom macroglobulinemia Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C88.2 Heavy chain disease Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C88.3 Immunoproliferative small intestinal disease Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C88.4 Extranodal marginal zone B-cell lymphoma of 

mucosa-associated lymphoid tissue [MALTlymphoma]

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C88.8 Other malignant immunoproliferative diseases Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C88.9 Malignant immunoproliferative disease, 

unspecified

Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C90 Multiple myeloma and malignant plasma cell 

neoplasms

Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C91.0 Acute lymphoblastic leukemia Red bone marrow Red bone marrow Acute lymphoid leukemia

C91.1 Chronic lymphocytic leukemia of B-cell type Specialh Specialh Chronic lymphocytic leukemia

C91.3 Prolymphocytic leukemia of B-cell type Red bone marrow Red bone marrow Leukemia, excl. CLL

C91.4 Hairy cell leukemia Red bone marrow Red bone marrow Lymphoma and multiple myeloma

C91.5 Adult T-cell lymphoma/leukemia (HTLV-1-

associated)

Red bone marrow Red bone marrow Leukemia, excl. CLL

C91.6 Prolymphocytic leukemia of T-cell type Red bone marrow Red bone marrow Leukemia, excl. CLL

C91.9 Lymphoid leukemia, unspecified Red bone marrow Red bone marrow Acute lymphoid leukemia

C91.A Mature B-cell leukemia Burkitt-type Red bone marrow Red bone marrow Leukemia, excl. CLL

C91.Z Other lymphoid leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C92.0 Acute myeloblastic leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.1 Chronic myeloid leukemia, BCR/ABL-positive Red bone marrow Red bone marrow Leukemia, excl. CLL and

Chronic myeloid leukemia

C92.2 Atypical chronic myeloid leukemia, BCR/ABLnegativeRed bone marrow Red bone marrow Leukemia, excl. CLL

C92.3 Myeloid sarcoma Red bone marrow Red bone marrow Leukemia, excl. CLL

C92.4 Acute promyelocytic leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.5 Acute myelomonocytic leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.6 Acute myeloid leukemia with 11q23-abnormality Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.9 Myeloid leukemia, unspecified Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.A Acute myeloid leukemia with multilineage 

dysplasia

Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute myeloid leukemia

C92.Z Other myeloid leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL

C93 Monocytic leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL

C94.0 Acute erythroid leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL

C94.2 Acute megakaryoblastic leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL

C94.3 Mast cell leukemia Red bone marrow Red bone marrow Leukemia, excl. CLL

C94.4 Acute panmyelosis with myelofibrosis Red bone marrow Red bone marrow Bone and

Lymphoma and multiple myeloma

C94.6 Myelodysplastic disease, not classified Red bone marrow Red bone marrow Bone and

Lymphoma and multiple myeloma

C94.8 Other specified leukemias Red bone marrow Red bone marrow Leukemia, excl. CLL

C95.0 Acute leukemia of unspecified cell type Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute lymphoid leukemia and

Acute myeloid leukemia

C95.1 Chronic leukemia of unspecified cell type Red bone marrow Red bone marrow Leukemia, excl. CLL and

Chronic myeloid leukemia

C95.9 Leukemia, unspecified Red bone marrow Red bone marrow Leukemia, excl. CLL and

Acute lymphoid leukemia and

Acute myeloid leukemia and

Chronic myeloid leukemia

C96.0 Multifocal and multisystemic (disseminated) 

Langerhans-cell histiocytosis

LN(TH) Skin Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, unspecifiedi LN(TH) Thyroid Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, headi LN(ET) Thyroid Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C96.20 Malignant mast cell neoplasm, thoraxi LN(TH) Lung Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, abdomi Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, axillai LN(TH) Lung Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, inguini Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, pelvici Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, spleeni Spleen Stomach Lymphoma and multiple myeloma

C96.20 Malignant mast cell neoplasm, multiplei LN(TH) Thyroid Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, unspecifiedi LN(TH) Thyroid Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, headi LN(ET) Thyroid Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, thoraxi LN(TH) Lung Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, abdomi Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, axillai LN(TH) Lung Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, inguini Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, pelvici Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, spleeni Spleen Stomach Lymphoma and multiple myeloma

C96.21 Aggressive systemic mastocytosis, multiplei LN(TH) Thyroid Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, unspecifiedi LN(TH) Thyroid Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, headi LN(ET) Thyroid Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, thoraxi LN(TH) Lung Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, abdomi Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, axillai LN(TH) Lung Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, inguini Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, pelvici Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, spleeni Spleen Stomach Lymphoma and multiple myeloma

C96.22 Mast cell sarcoma, multiplei LN(TH) Thyroid Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, unspecifiedi LN(TH) Thyroid Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, headi LN(ET) Thyroid Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, thoraxi LN(TH) Lung Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, abdomi Highest non-met org/tiss Stomach Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, axillai LN(TH) Lung Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, inguini Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, pelvici Highest non-met org/tiss Bladder Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, spleeni Spleen Stomach Lymphoma and multiple myeloma

C96.29 Other malignant mast cell neoplasm, multiplei LN(TH) Thyroid Lymphoma and multiple myeloma

C96.4 Sarcoma of dendritic cells (accessory cells) LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C96.9 Malignant neoplasm of lymphoid, hematopoietic 

and related tissue, unspecified

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

C96.A Histiocytic sarcoma LN(TH) Thyroid Lymphoma and multiple myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

C96.Z Other specified malignant neoplasms of lymphoid, 

hematopoietic and related tissue

LN(TH) Thymus/lungg Lymphoma and multiple myeloma

D00.0 Carcinoma in situ of lip, oral cavity, and pharynx Highest non-met org/tiss Thyroid Oral cav. and pharynx

D00.1 Carcinoma in situ of esophagus Esophagus Esophagus Esophagus

D00.2 Carcinoma in situ of stomach Stomach Stomach Stomach

D01.0 Carcinoma in situ of colon Colon Colon Colon

D01.1 Carcinoma in situ of rectosigmoid junction LLI Colon Rectum

D01.2 Carcinoma in situ of rectum LLI Colon Rectum

D01.3 Carcinoma in situ of anus and anal canal LLI Colon Rectum

D01.4 Carcinoma in situ of other and unspecified part of 

intestine

Colon Colon All digestive

D01.5 Carcinoma in situ of liver, gallbladder and bile 

ducts

Liver Liver Liver

D01.7 Carcinoma in situ of other specified digestive 

organs

Highest non-met org/tiss Remaindere All digestive

D01.9 Carcinoma in situ of digestive organ, unspecified Highest non-met org/tiss Remaindere All digestive

D02.0 Carcinoma in situ of larynx ET2 Esophagus Other respiratory

D02.1 Carcinoma in situ of trachea BBj Thyroid Lung

D02.2 Carcinoma in situ of bronchus and lung Lung Lung Lung

D02.3 Carcinoma in situ of other parts of respiratory 

system

Medical review Medical review Other respiratory

D02.4 Carcinoma in situ of respiratory system, 

unspecified

Lung Lung Other respiratory

D03 Melanoma in situ Skin Skin Malignant melanoma

D04 Carcinoma in situ of skin Skin Skin Malignant melanoma and

Non- melanoma skin-basal Cell and

Non-melanoma skin-squamous cellk

D05 Lobular carcinoma in situ of breast Breast Breast Breast

D06 Carcinoma in situ of cervix uteri Uterus Uterus Female genitalia less ovary

D07.0 Carcinoma in situ of endometrium Uterus Uterus Female genitalia less ovary

D07.1 Carcinoma in situ of vulva Skin Uterus Female genitalia less ovary and

Ovary

D07.2 Carcinoma in situ of vagina Uterus Uterus Female genitalia less ovary and

Ovary

D07.3 Carcinoma in situ of other and unspecified female 

genital organs

Uterus Uterus Female genitalia less ovary and

Ovary

D07.4 Carcinoma in situ of penis Testes Testes All male genitalia

D07.5 Carcinoma in situ of prostate Highest non-met org/tiss Bladder All male genitalia
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

D07.6 Carcinoma in situ of other and unspecified male 

genital organs

Testes Testes All male genitalia

D09.0 Carcinoma in situ of bladder Bladder Bladder Bladder

D09.10 Carcinoma in situ of unspecified urinary organ Medical review Liver Urinary organs less bladder

D09.19 Carcinoma in situ of other urinary organs Medical review Liver Urinary organs less bladder

D09.2 Carcinoma in situ of eye Brain Eye lens Eye

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (thyroid)i

Thyroid Thyroid Thyroid

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (adrenal)i

Adrenals Thyroid/remaindera Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (parathyroid)i

Thyroid Thyroid Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (pituitary)i

Brain Thyroid/remaindera Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (pineal gland)i

Brain Thyroid/remaindera Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (carotid body)i

Brain Thyroid Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (paraganglia NEC)i

Brain Thyroid/remaindera Other endocrine glands

D09.3 Carcinoma in situ of thyroid and other endocrine 

glands (endocrine NEC/NOS)i

Medical review Remaindere Other endocrine glands

D09.8 Carcinoma in situ of other specified sites Highest non-met org/tiss Remaindere Other and ill-defined sites

D09.9 Carcinoma in situ, unspecified Highest non-met org/tiss Remaindere Other and ill-defined sites

D37.01 Neoplasm of uncertain behavior of lip Highest non-met org/tiss Skin Oral cav. and pharynx

D37.02 Neoplasm of uncertain behavior of tongue Highest non-met org/tiss Thyroid/remaindera Oral cav. and pharynx

D37.03 Neoplasm of uncertain behavior of the major 

salivary glands

Highest non-met org/tiss Thyroid/remaindera Oral cav. and pharynx

D37.04 Neoplasm of uncertain behavior of the minor 

salivary glands

Highest non-met org/tiss Thyroid/remaindera Oral cav. and pharynx

D37.05 Neoplasm of uncertain behavior of pharynx Highest non-met org/tiss Thyroid/remaindera Oral cav. and pharynx

D37.09 Neoplasm of uncertain behavior of other specified 

sites of the oral cavity

Highest non-met org/tiss Thyroid/remaindera Oral cav. and pharynx

D37.1 Neoplasm of uncertain behavior of stomach Stomach Stomach Stomach

D37.2 Neoplasm of uncertain behavior of small intestine SI Stomach All digestive

D37.3 Neoplasm of uncertain behavior of appendix ULI Colon Colon

D37.4 Neoplasm of uncertain behavior of colon Colon Colon Colon

D37.5 Neoplasm of uncertain behavior of rectum LLI Colon Rectum
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

D37.6 Neoplasm of uncertain behavior of liver, 

gallbladder and bile ducts

Liver Liver Liver

D37.8 Neoplasm of uncertain behavior of other specified 

digestive organs

Colon Colon All digestive

D37.9 Neoplasm of uncertain behavior of digestive 

organ, unspecified

Colon Colon All digestive

D38.0 Neoplasm of uncertain behavior of larynx ET2 Esophagus Other respiratory

D38.1 Neoplasm of uncertain behavior of trachea, 

bronchus and lung

Lung Lung Lung

D38.2 Neoplasm of uncertain behavior of pleura Medical review Lung Other respiratory

D38.3 Neoplasm of uncertain behavior of mediastinum Highest non-met org/tiss Thymus Other respiratory

D38.4 Neoplasm of uncertain behavior of thymus Thymus Thymus Other respiratory

D38.5 Neoplasm of uncertain behavior of other 

respiratory organs

Medical review Lung Other respiratory

D38.6 Neoplasm of uncertain behavior of respiratory 

organ, unspecified

Medical review Lung Other respiratory

D39.0 Neoplasm of uncertain behavior of uterus Uterus Uterus Female genitalia, less ovary

D39.1 Neoplasm of uncertain behavior of ovary Ovaries Ovaries Ovary

D39.2 Neoplasm of uncertain behavior of placenta Uterus Uterus Female genitalia, less ovary

D39.8 Neoplasm of uncertain behavior of other specified 

female genital organs

Medical review Uterus Female genitalia, less ovary

D39.9 Neoplasm of uncertain behavior of female genital 

organ, unspecified

Medical review Uterus Female genitalia, less ovary

D40.0 Neoplasm of uncertain behavior of prostate Highest non-met org/tiss Bladder All male genitalia

D40.1 Neoplasm of uncertain behavior of testis Testes Testes All male genitalia

D40.8 Neoplasm of uncertain behavior of other specified 

male genital organs

Testes Testes All male genitalia

D40.9 Neoplasm of uncertain behavior of male genital 

organ, unspecified

Testes Testes All male genitalia

D41.0 Neoplasm of uncertain behavior of kidney Kidney Liver Urinary organs less bladder

D41.1 Neoplasm of uncertain behavior of renal pelvis Kidney Liver Urinary organs less bladder

D41.2 Neoplasm of uncertain behavior of ureter Kidney Liver Urinary organs less bladder

D41.3 Neoplasm of uncertain behavior of urethra Highest non-met org/tiss Liver Urinary organs less bladder

D41.4 Neoplasm of uncertain behavior of bladder Bladder Bladder Bladder

D41.8 Neoplasm of uncertain behavior of other specified 

urinary organs

Medical review Liver Urinary organs less bladder

D41.9 Neoplasm of uncertain behavior of unspecified 

urinary organ

Medical review Liver Urinary organs less bladder

D42 Neoplasm of uncertain behavior of meninges Brain Thyroid/remaindera Nervous system
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

D43.0 Neoplasm of uncertain behavior of brain, 

supratentorial

Brain Thyroid/remaindera Nervous system

D43.1 Neoplasm of uncertain behavior of brain, 

infratentorial

Brain Thyroid/remaindera Nervous system

D43.2 Neoplasm of uncertain behavior of brain, 

unspecified

Brain Thyroid/remaindera Nervous system

D43.3 Neoplasm of uncertain behavior of cranial nerves Brain Thyroid/remaindera Nervous system

D43.4 Neoplasm of uncertain behavior of spinal cord Brain Thyroid/remaindera Nervous system

D43.8 Neoplasm of uncertain behavior of other specified 

parts of central nervous system

Medical review Remaindere Nervous system

D43.9 Neoplasm of uncertain behavior of central 

nervous system, unspecified

Medical review Remaindere Nervous system

D44.0 Neoplasm of uncertain behavior of thyroid gland Thyroid Thyroid Thyroid

D44.1 Neoplasm of uncertain behavior of adrenal gland Adrenal Liver Urinary organs less bladder

D44.2 Neoplasm of uncertain behavior of parathyroid 

gland

Thyroid Thyroid Other endocrine glands

D44.3 Neoplasm of uncertain behavior of pituitary gland Brain Thyroid/remaindera Thyroid

D44.4 Neoplasm of uncertain behavior of 

craniopharyngeal duct

Brain Thyroid/remaindera Thyroid

D44.5 Neoplasm of uncertain behavior of pineal gland Brain Thyroid/remaindera Thyroid

D44.6 Neoplasm of uncertain behavior of carotid body Highest non-met org/tiss Remaindere Connective tissue

D44.7 Neoplasm of uncertain behavior of aortic body 

and other paraganglia

Highest non-met org/tiss Remaindere Connective tissue

D44.9 Neoplasm of uncertain behavior of unspecified 

endocrine gland

Medical review Remaindere Thyroid

D45 Polycythemia vera Red bone marrow Red bone marrow Bone

D46 Myelodysplastic syndromes Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma

D47.01 Cutaneous mastocytosis Skin Skin Lymphoma and multiple myeloma

D47.02 Systemic mastocytosis Red bone marrow Red bone marrow Lymphoma and multiple myeloma

D47.09 Other mast cell neoplasms of uncertain behavior Red bone marrow Red bone marrow Lymphoma and multiple myeloma

D47.1 Chronic myeloproliferative disease Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma

D47.3 Essential (hemorrhagic) thrombocythemia Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma

D47.4 Osteomyelofibrosis Red bone marrow Red bone marrow Bone

D47.9 Neoplasm of uncertain behavior of lymphoid, 

hematopoietic and related tissue, unspecified

Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma
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ICD-10

code Cancer code explanation Internal organ External organ IREP model

D47.Z2 Castleman disease Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma

D47.Z9 Other specified neoplasms of uncertain behavior 

of lymphoid, hematopoietic and related tissue

Red bone marrow Red bone marrow Bone and lymphoma and multiple 

myeloma

D48.0 Neoplasm of uncertain behavior of bone and 

articular cartilage

Bone surface Bone surface Bone

D48.1 Neoplasm of uncertain behavior of connective and 

other soft tissue

Medical review Remaindere Connective tissue

D48.2 Neoplasm of uncertain behavior of peripheral 

nerves and autonomic nervous system

Medical review Remaindere Nervous system

D48.3 Neoplasm of uncertain behavior of 

retroperitoneum

Highest non-met org/tiss Colon All digestive

D48.4 Neoplasm of uncertain behavior of peritoneum Highest non-met org/tiss Colon All digestive

D48.5 Neoplasm of uncertain behavior of skin Skin Skin Malignant melanoma and

Non-melanoma skin-basal cell and

Non-melanoma skin-squamous cellk

D48.6 Neoplasm of uncertain behavior of breast Breast Breast Breast

D48.7 Neoplasm of uncertain behavior of other specified 

sites

Medical review Remaindere Other and ill-defined sites

D48.9 Neoplasm of uncertain behavior, unspecified Medical review Remaindere Other and ill-defined sites

D49.0 Neoplasm of unspecified behavior of digestive 

system

Medical review Stomach All digestive

D49.1 Neoplasm of unspecified behavior of respiratory 

system

Medical review Lung Lung and other respiratory

D49.2 Neoplasm of unspecified behavior of bone/skin 

(bone)i

Bone surface Bone surface Bone

D49.2 Neoplasm of unspecified behavior of bone/skin 

(skin)i

Skin Skin Non-melanoma skin-basal cell or

Non-melanoma skin-squamous celld

D49.3 Neoplasm of unspecified behavior of breast Breast Breast Breast

D49.4 Neoplasm of unspecified behavior of bladder Bladder Bladder Bladder

D49.51 Neoplasm of unspecified behavior of kidney Kidney Liver Urinary organs less bladder

D49.59 Neoplasm of unspecified behavior of other 

genitourinary organ (female)

Medical review Bladder Female genitalia less ovary and

ovary and

Urinary organs less bladder and

Bladder

D49.59 Neoplasm of unspecified behavior of other 

genitourinary organ (male)

Medical review Testes All male genitalia and

Urinary organs less bladder and

Bladder

D49.6 Neoplasm of unspecified behavior of brain Brain Thyroid/remaindera Nervous system
 

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ICD-10

code Cancer code explanation Internal organ External organ IREP model

D49.7 Neoplasm of unspecified behavior of other parts

of nervous systemi

Medical review Remaindere Nervous system

D49.7 Neoplasm of unspecified behavior of endocrine 

glandsi

Medical review Remaindere Thyroid and

Other endocrine glands

D49.8 Neoplasm of unspecified behavior of retina, 

choroid, and other specified sites

Medical review Remaindere Other and ill-defined sites

D49.9 Neoplasm of unspecified behavior of unspecified 

site

Medical review Remaindere Other and ill-defined sites

D68.5 Primary thrombophilia Red bone marrow Red bone marrow Bone

D68.6 Other thrombophilia Red bone marrow Red bone marrow Bone

D74.8 Other methemoglobinemias Red bone marrow Red bone marrow Bone

D74.9 Methemoglobinemia, unspecified Red bone marrow Red bone marrow Bone

D75.81 Myelofibrosis Red bone marrow Red bone marrow Bone

D75.89 Other specified diseases of blood and bloodforming organsRed bone marrow Red bone marrow Bone

D75.9 Disease of blood and blood-forming organs, 

unspecified

Red bone marrow Red bone marrow Bone

D89.2 Hypergammaglobulinemia, unspecified Red bone marrow Red bone marrow Bone

E31.22 Multiple endocrine neoplasia [MEN] type IIA Thyroid Thyroid Thyroid

Q85.00 Neurofibromatosis, unspecified Medical review Remaindere Nervous system

Q85.01 Neurofibromatosis, type 1 Medical review Remaindere Nervous system

Q85.02 Neurofibromatosis, type 2 Medical review Remaindere Nervous system

a. See discussion in Section 4.3. 

b. See discussion in Section 4.8. 

c. For ICD-10 code C22.1, for cancers that are described as cancer of the intrahepatic ducts, select liver as the internal organ. For those that are described as 

gallbladder carcinoma, select gallbladder as the internal organ. If the description is unclear, a medical review should be conducted to determine the appropriate 

internal organ of interest.

d. See discussion in Section 4.7. 

e. See discussion in Section 4.4. 

f. See discussion in Section 3.2. 

g. The external target organ should be the lung if the lymphoma is known to be a B-cell variety. The target should be the thymus if the lymphoma is known to be a 

T-cell variety or if the variety is unknown.

h. See discussion in Section 4.11. 

i. See discussion in Section 4.2.1. 

j. See discussion in Section 4.12. 

k. For ICD-10 codes D04 and D48.5, if the type of cancer is specified by DOL (“Malignant melanoma, Non-melanoma skin-Squamous cell, or Non-melanoma skin-Basal 

cell”), use only the specified IREP model (note that Bowen’s disease is another name for squamous cell carcinoma in situ). If the cancer is not specified, run all listed 

IREP models as discussed in Section 4.6. 
 

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Table 3-2. Selection of primary cancer(s) for dose reconstruction from secondary cancer codes. 

ICD-10

code Secondary cancer code explanation ICD-10 code of likely primary cancersa,b,c

C77.0 Lymph nodes of head, face and neck C02, C09(M), C10(M), C14(F), C32(M), C34, C43, C44, C50(F), C73(F)

C77.1 Intrathoracic lymph nodes C15(M), C34, C50(F)

C77.2 Intra-abdominal lymph nodes C15(M), C16(M), C18, C25(F), C34, C50(F), C53(F), C61(M), C64, C68, C84(F) (excluding 

C84.6, C84.7), C91.4(F), C96(F)

C77.3 Lymph nodes of axilla and upper limb C34, C43, C50(F)

C77.4 Inguinal and lower limb lymph nodes C21(M), C34, C43, C44(F), C60(M)

C77.5 Intrapelvic lymph nodes C18(M), C21(F), C34(M), C54(F), C61(M), C67

C77.8 Lymph nodes of multiple regions C15(M), C16(M), C18(M), C34, C50(F)

C77.9 Lymph node, unspecified C15(M), C16, C18, C34, C43, C50(F), C61(M)

C78.0 Lung C18, C34, C43(M), C50(F), C61(M), C67(M), C64, C68

C78.1 Mediastinum C15(M), C34, C50(F)

C78.2 Pleura C15(M), C18(M), C34, C50(F), C57(F), C61(M), C64(M), C68(M)

C78.3 Other respiratory organs C15, C18(M), C32, C34, C44(M), C50(F), C61(M), C73(F)

C78.4 Small intestine C17, C18, C25, C34, C49, C43(M), C50(F), C57(F), C64(M), C68(M)

C78.5 Large intestine and rectum C18, C21, C34, C50(F), C57(F), C61(M)

C78.6 Retroperitoneum and peritoneum C16, C18, C21(M), C25, C34(M), C49, C50(F), C57(F)

C78.7 Liver and intrahepatic bile duct C16(M), C18, C21(M), C25, C34, C50(F)

C78.8 Other digestive organs C15(M), C16, C18, C25, C34, C50(F), C61(M)

C7B.01 Distant lymph nodes C15(M), C16, C18, C34, C43, C50(F),C61(M)

C7B.02 Liver C16(M), C18, C21(M), C25, C34, C50(F)

C7B.03 Bone C34, C50(F), C61(M)

C7B.04 Peritoneum C16, C18, C21(M), C25, C34(M), C49, C50(F), C57(F)

C7B.1 Merkel cell carcinoma C18, C34, C49(M), C43, C44(M), C50(F), C64(M), C68(M)

C79.0 Kidney and renal pelvis C18, C34, C50(F), C53(F), C61(M), C67, C64, C68, C84(F) (excluding C84.6, C84.7), C91.4(F), 

C96(F)

C79.1 Urinary organs C18, C50(F), C57(F), C61(M), C67, C64(F), C68(F)

C79.2 Skin C18, C34, C49(M), C43, C44(M), C50(F), C64(M), C68(M)

C79.3 Brain and cerebral meninges C34, C43(M), C50(F)

C79.4 Other part of nervous system C34, C43(M), C50(F), C61(M), C84 (excluding C84.6, C84.7), C91.4, C96

C79.5 Bone and bone marrow C34, C50(F), C61(M)

C79.6 Ovary C18(F), C50(F), C57(F)

C79.7 Adrenal gland C18(F), C34, C50(F)

C79.8 Other specified sites C18, C34, C43(M), C50(F), C57(F), C61(M), C67(M)

C79.9 Unspecified site C18, C34, C43(M), C50(F), C57(F), C61(M), C67(M)

J91.0 Malignant pleural effusion C15(M), C18(M), C34, C50(F), C57(F), C61(M), C64(M), C68(M)

R18.0 Malignant ascites C16, C18, C21(M), C25, C34(M), C49, C50(F), C57(F)

a. “M” indicates cancer site should be used for males only; “F” indicates cancer site should be used for females only.

b. For likely primary cancer sites that have multiple possible IMBA or external organs, see Section 4.9. 

c. If “C44” is indicated as a likely primary cancer, the “non-melanoma skin-basal cell (BCC)” model should be used.
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4.0 DISCUSSION

4.1 HIGHEST NONMETABOLIC ORGAN

The dose estimate for a number of tissues is based on the highest nonmetabolic organ dose, which is 

designated as “Highest non-met org/tiss” in the table. Metabolic organs are those that are specifically 

modeled by the ICRP for a particular element. The biokinetic models are based on the behavior of 

the particular element in the body, so the metabolic organs vary with the element of interest. The 

metabolic organs include the gastrointestinal tract from ICRP Publication 30 (ICRP 1979) and, in the 

case of inhalation, the respiratory tract from ICRP Publication 66 (ICRP 1994).

When the energy that is emitted by a radionuclide is primarily alpha or beta radiation, the soft tissue 

compartment becomes the primary source of dose. This compartment contains all the organs that are 

not specifically accounted for in the metabolic model (i.e., nonmetabolic organs). This compartment 

accounts for the dose that is delivered by material that is actually deposited in that tissue. Under this 

scenario most of the nonmetabolic organs receive the same dose. 

An additional source of exposure to the tissue is known as photon cross-irradiation. Cross-irradiation 

is the exposure to a tissue from photons that originate in other tissues. For radionuclides for which 

photon emissions are a major source of the emitted energy, the nonmetabolic organ doses can vary 

due to their relative proximity to the metabolic organs in which the radionuclides concentrate. 

IMBA calculates the dose from both sources of irradiation (i.e., alpha and beta radiation to the source 

organ and photon cross-irradiation from a different source organ) and sums them. Therefore, 

choosing the highest nonmetabolic organ is a realistic assumption with only minor (if any) 

overestimation.

It is conceivable that a situation could arise in which a photon-emitting radionuclide causes a large 

difference in doses that are delivered to nonmetabolic organs. In accordance with OCAS-IG-002, 

Internal Dose Reconstruction Implementation Guideline (NIOSH 2002b), it is acceptable in these 

situations to base the dose on an organ that is not the highest nonmetabolic organ. The choice in 

these cases should be based on the proximity of the model organ to the actual organ of interest. For 

example, the thymus is relatively close to the thyroid so would not be included when determining the 

highest nonmetabolic organ for an intake of 131I. Further discussion may be found in ORAUT-OTIB0060, Internal Dose Reconstruction (ORAUT 2018).

4.2 MEDICAL REVIEW

Due to the complexity of determining the appropriate organs and tissues for some ICD-10 code 

cancers, a medical review by an Oak Ridge Associated Universities (ORAU) Team physician is 

required to determine the organs and tissues to use in IMBA for those cancers. These cancers have 

been designated in Table 3-1 as “Medical review.” The ORAU Team physician will recommend to the 

dose reconstructor the appropriate organs and tissues for dose estimation purposes. A copy of this 

medical review will be placed in the claim file.

4.2.1 Medical Review for Appropriate Line in Table 3-1

Although the ICD-10 coding system is generally more specific than the previous ICD-9 system, there 

are some exceptions to this rule where the older system was more specific than ICD-10. In these 

cases, multiple lines have been entered into Table 3-1 for this ICD-10 code with different options for 

the internal organ, external organ, and IREP model, depending on the location of the cancer. If the 

cancer description from DOL is not specific enough to select the appropriate line, a medical review is 

required to determine which line (by “Cancer code explanation” is most appropriate for assessment). 
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The organs and IREP models are already selected for each line in the table, so only the appropriate 

line needs to be determined by the medical review.

For example, ICD-10 code C96.20 refers to “Malignant mast cell neoplasm” without giving a specific 

location. Because location is key to determining the appropriate organs of interest, there are nine 

separate lines for ICD-10 code C96.20 corresponding to different locations. The line with the 

appropriate location should be used for assessment. If a medical review cannot determine the 

location, the first line (for unspecified location) should be used because it is most favorable to 

claimants.

There are instances that require a medical review to determine the correct line to use as well as the 

appropriate internal organ for assessment. An example of this is ICD-10 code D49.7, where not only 

does the medical review need to determine the appropriate line (nervous system versus endocrine 

glands), it also needs to determine the internal organ of interest. Both selections should be made

during a single medical review.

4.3 THYROID OR REMAINDER SELECTION FOR EXTERNAL DOSE

For cancer sites for which Table 3-1 lists “Thyroid/Remainder” for the external organ selection, there 

is no external dose model for the organ of interest and the organ is in proximity to the thyroid. The 

thyroid has higher organ dose conversion factors than the remainder selection, which maximizes the 

dose. If a more realistic dose assessment is required rather than a maximizing dose assessment, the 

remainder organ should be selected to calculate dose.

4.4 REMAINDER SELECTION FOR EXTERNAL DOSE

For cancer sites for which Table 3-1 lists “Remainder” for the external organ selection, the organ 

location should be determined through a medical review and an organ in physical proximity should be 

selected.

If the medical review determines there are cancers of multiple organs denoted by a single ICD-10 

code by DOL, the information for each of those organs should be assessed and the largest of the 

outcomes used for the assessment. If the medical review determines that the cancer site is unknown, 

the remainder organ should be selected as the model to apply dose since that value represents the 

collection of organs/tissues that are not defined separately in ICRP Report 60 (ICRP1991) as 

discussed in ICRP Report 74 (ICRP1996). 

4.5 BLADDER

If Table 3-1 lists “Bladder” with no modifier, this represents the urinary bladder. If the organ of interest 

is the gallbladder, “Gallbladder” is specified clearly.

4.6 MULTIPLE IREP MODELS

If Table 3-1 lists multiple IREP models for a given cancer type, the IREP model(s) to be run is 

determined based on the use of the words “or” and “and” in the IREP Model column.

For multiple IREP models that are connected by “or”, only the model that best fits the actual cancer 

type should be selected and run in IREP. For example, ICD-10 code C44.00 is listed as “Nonmelanoma skin-Basal cell or Non-melanoma skin-Squamous cell” in the IREP Model column. The 

appropriate IREP model should be selected and run based on the type of skin cancer (basal cell or 

squamous cell) that is listed in the claim’s NIOSH Referral Summary Document (NRSD). 
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For multiple IREP models that are connected by the word “and”, separate IREP runs should be made 

for each listed model, and compensability would be determined based on the model that results in the 

highest POC, which is favorable to the claimant. For example, ICD-10 code D07.1 is listed as 

“Female genitalia less ovary and Ovary” in the IREP Model column. Separate IREP runs should be 

made using each model, and compensability would be based on the model that results in the highest 

POC.

4.7 SKIN CANCER MODEL CLARIFICATION

If the IREP Model column lists “Non-melanoma skin-basal cell or Non-melanoma skin-squamous cell”, 

and the skin cancer is named but not clearly as squamous or basal, the non-melanoma squamous cell 

model is to be used. This model was developed with all named, non-melanoma, non-basal cell 

carcinomas included.

For example, for ICD-10 code C44, if the named cancer is fibrosarcoma of skin, this is not clearly 

either squamous cell or basal cell carcinoma. However, because fibrosarcoma is a specific, named 

cancer, the non-melanoma squamous cell model should be used (rather than using both models and 

selecting the higher POC).

The only exceptions to this rule are the named cancers basalsquamous cell carcinoma and 

squamobasal cell carcinoma. Because these are transitional forms, both IREP models should be run 

and the one that yields the larger POC should be selected.

For the ICD-10 code C44 (skin cancers), the fifth digit clarifies the type of skin cancer (if known) as 

follows: 

0 = Unspecified type of cancer – compare BCC and SCC

1 = Basal cell – use BCC

2 = Squamous cell – use SCC

9 = Other specified – use SCC unless specified as basalsquamous cell carcinoma or 

squamobasal cell carcinoma (see direction above)

For instances where the SCC and BCC models are to be compared, the BCC model can be run and 

used as the more favorable to the claimant of the two models with no need to run the SCC model. 

This is due to the fact that all of the dose inputs are identical and the BCC model will always yield a 

larger POC value than the SCC model.

4.8 ADENOCARCINOMA OF THE DISTAL (LOWER THIRD) ESOPHAGUS

If adenocarcinoma is indicated in the distal esophagus (also known as the lower third, abdominal, 

lower thoracic esophagus, gastroesophageal, cardioesophageal junction, or esophageal cardia), the 

appropriate IMBA, external, and IREP organ model is the stomach. To use the stomach model, both

conditions must be met (adenocarcinoma and correct location). If either condition is not met, the 

esophagus for the IMBA, external, and IREP organ model is appropriate. The specific codes 

potentially impacted are C15.5 and C15.8.

4.9 SECONDARY CANCERS – LIKELY PRIMARY CANCER SITES WITH MULTIPLE IMBA, 

EXTERNAL, AND IREP ORGAN MODEL OPTIONS

For secondary cancers with unknown primary cancer sites, the likely primary cancer sites are listed in 

Table 3-2. Because the likely primary cancer sites are listed only by ICD-10 code (three-character 

code with no extensions), it is possible for a single likely primary cancer site to have multiple options 
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for IMBA, external, and IREP organ model selection. In this case, each possible option must be 

assessed, and the option that yields the largest POC should be submitted.

For example, secondary cancer code C77.2 has a likely primary cancer site of ICD-10 code C68. 

ICD-10 code C68 has an Internal Dosimetry Organ selection of highest nonmetabolic organ and 

bladder depending on the extension of the ICD-10 code. Because it is an unknown location, each of 

these organs must be run for internal dose purposes, and the one yielding the largest dose over the 

exposure period should be selected for use in the IREP run.

A special case of this also arises for secondary cancer code C77.2, which has another likely primary 

cancer site of ICD-10 code C18. ICD-10 code C18 has an Internal Dosimetry Organ selection of 

upper large intestine (ULI), lower large intestine (LLI), and colon, depending on the extension of the 

ICD-10 code. Normally, each of these organs would be run for internal dose purposes, and the one 

yielding the largest dose over the exposure period should be selected for use in the IREP run.

To facilitate the dose reconstruction process, a comparison of all nuclide and type combinations 

available in the CAD tool was made for ULI and LLI (ORAUT 2011). For the majority of nuclides, the 

LLI is more favorable to claimants than the ULI. The exceptions are noted below.

ULI yields a larger dose for:

• I-133

• I-134

• I-135

• Mn-56

• Na-24

• Pa-234

• Se-75

• Te-131

The comparison of ULI and LLI was inconclusive for the following radionuclides, so both need to be 

run and compared:

• Eu-152

• Eu-154

• Ac-227 (Type F only)

• Ag-110m (Type F only)

For all remaining individual nuclide and type combinations in the CAD tool, LLI yields an equal or 

larger dose than the ULI. Therefore, ULI calculations do not need to be run for them.

In addition, because the colon is a weighted average of the ULI and LLI, the colon does not need to 

be run at all for comparison; the ULI or LLI will always be greater than an average of the two.

4.10 MULTIPLE SECONDARY CANCERS WITH UNKNOWN PRIMARY CANCER SITE OR 

MULTIPLE PRIMARY AND SECONDARY CANCERS

In some claims, multiple secondary cancers with unknown primary cancer locations might be 

indicated. In such cases, unless DOL specifically states differently: each likely primary cancer site 

from each secondary cancer is to be treated separately, with individual IREP POC determinations, 

and combined as separate primary cancers.
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For example, consider a claim that has indicated separate secondary cancers of C77.0 (Lymph nodes 

of head, face, and neck) and C78.7 (Liver, specified as secondary), with no indication of the cancers 

being metastasized from a single unknown primary cancer site. When each of the likely primary 

cancer sites is assessed, ICD-10 code C33 (Lung) yields the largest POC for each at 38% (for this 

example only). Because it is possible that each secondary cancer came from a separate likely 

primary lung cancer, the POC results for each likely primary lung cancer should be combined to yield 

a final POC of 61.56% (per multiple cancer calculation in IREP).

The same type of situation might occur when primary and secondary cancers are both indicated by 

DOL. The same logic applies that, unless specifically directed otherwise by DOL, each cancer should 

be treated as a separate cancer for the determination of POC and for combining them for the final 

POC. It should not be assumed by the dose reconstructor that any listed secondary cancer has 

metastasized from another listed primary cancer.

4.11 CHRONIC LYMPHOCYTIC LEUKEMIA

Chronic lymphocytic leukemia (CLL) originates in the B lymphocytes rather than in a well-defined 

organ as with other cancers. These lymphocytes are distributed throughout the lymph system and 

can travel throughout the body with their inventories in various compartments of the body changing 

significantly with age, gender, health status, and other factors. Estimation of dose to the cancer site 

for CLL cases requires the calculation of the radiation dose to this population of CLL precursor cells. 

This is more complex than dose assessment to other cancer sites because CLL precursor cells can 

be present in different compartments of the lymphatic system throughout the body, and these 

compartments can receive substantially different doses.

Due to the complex modeling necessary for CLL, a specific organ is not defined in Table 3-1. The 

method of assessing internal and external doses to various organs in the model is given in 

ORAUT-OTIB-0082, Dose Reconstruction Method for Chronic Lymphocytic Leukemia (ORAUT 2012). 

When referring to the organ of interest in the dose reconstruction, the term “B lymphocytes” should be 

used.

4.12 ORGAN BB FOR CARCINOMA IN SITU OF TRACHEA

Due to its specific location, ICD-10 code D02.1 (Carcinoma in situ of trachea) states to use BB as the 

internal organ of interest. This is a specific location based on the respiratory tract from ICRP 

Publication 66 (ICRP 1994). The IMBA program does not give the dose specifically to the BB region, 

but rather calculates dose to the BBseq and BBbas regions (secretory and basal cells, respectively). 

Based on guidance in Section 9.4.3.1 in Publication 66, the BB region is the average of the BBseq and 

BBbas regions.
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