Q: A patient diagnosed with breast cancer by a core biopsy of a supraclavicular lymph node followed by a mastectomy with seven axillary lymph nodes removed. How do you code regional nodes examined, 07 or 08?
A: Code 08, per CS general instructions if the positive aspiration or core biopsy is from a node in a “different” node region, include the node in the count of regional nodes examined/positive. The supraclavicular lymph node is in a “different” but regional lymph node chain (per AJCC). Do not count a positive aspiration or core biopsy of a lymph node in the “same” lymph node chain removed at surgery as an additional node in regional nodes examined/positive when there are positive nodes in the resection.