(a) In claims for which the primary cancer site cannot be determined, but a site of metastasis is known, DOL will calculate probability of causation estimates for various likely primary sites. Table 1, below, indicates the primary cancer site(s) DOL will use in NIOSH-IREP when the primary cancer site is unknown.
Table 1
Primary cancers (ICD-9 codes \3\) for which probability of causation is to be calculated, if only a secondary cancer site is known. ``M'' indicates cancer site should be used for males only, and ``F'' indicates the cancer site should be used for females only. A glossary of cancer descriptions for each ICD-9 code is provided in appendix A to this part.---------------------------------------------------------------------------
\3\ The International Classification of Diseases Clinical Modification (9th Revision) Volume I&II.; [1991] Department of Health and Human Services Publication No. (PHS) 91-1260, U.S. Government Printing Office, Washington D.C. ------------------------------------------------------------------------Secondary cancer (ICD-9 code) ICD-9 code of likely primary cancers------------------------------------------------------------------------Lymph nodes of head, face and 141, 142 (M), 146 (M), 149 (F), 161 (M),
neck (196.0). 162, 172, 173, 174 (F), 193 (F).Intrathoracic lymph nodes 150 (M), 162, 174 (F).
(196.1).Intra-abdominal lymph nodes 150 (M), 151 (M), 153, 157 (F), 162, 174
(196.2). (F), 180 (F), 185 (M), 189, 202 (F).Lymph nodes of axilla and 162, 172, 174 (F).
upper limb (196.3).Inguinal and lower limb lymph 154 (M), 162, 172, 173 (F), 187 (M).
nodes (196.5).Intrapelvic lymph nodes 153 (M), 154 (F), 162 (M), 180 (F), 182
(196.6). (F), 185 (M), 188.Lymph nodes of multiple sites 150 (M), 151 (M), 153 (M), 162, 174 (F).
(196.8).Lymph nodes, site unspecified 150 (M), 151, 153, 162, 172, 174 (F), 185
(196.9). (M).Lung (197.0)................. 153, 162, 172 (M), 174 (F), 185 (M), 188
(M), 189.Mediastinum (197.1).......... 150 (M), 162, 174 (F).Pleura (197.2)............... 150 (M), 153 (M), 162, 174 (F), 183 (F),
185 (M), 189 (M).Other respiratory organs 150, 153 (M), 161, 162, 173 (M), 174 (F),
(197.3). 185 (M), 193 (F).Small intestine, including 152, 153, 157, 162, 171, 172 (M), 174
duodenum (197.4). (F), 183 (F), 189 (M).Large intestine and rectum 153, 154, 162, 174 (F), 183 (F), 185 (M).
(197.5).Retroperitoneum and 151, 153, 154 (M), 157, 162 (M), 171, 174
peritoneum (197.6). (F), 182 (F), 183 (F).Liver, specified as secondary 151 (M), 153, 154 (M), 157, 162, 174 (F).
(197.7).Other digestive organs 150 (M), 151, 153, 157, 162, 174 (F), 185
(197.8). (M).Kidney (198.0)............... 153, 162, 174 (F), 180 (F), 185 (M), 188,
189, 202 (F).Other urinary organs (198.1). 153, 174 (F), 180 (F), 183 (F), 185 (M),
188, 189 (F).Skin (198.2)................. 153, 162, 171 (M), 172, 173 (M), 174 (F),
189 (M).Brain and spinal cord (198.3) 162, 172 (M), 174 (F).Other parts of nervous system 162, 172 (M), 174 (F), 185 (M), 202.
(198.4).Bone and bone marrow (198.5). 162, 174 (F), 185 (M).Ovary (198.6)................ 153 (F), 174 (F), 183 (F).Suprarenal gland (198.7)..... 153 (F), 162, 174 (F).Other specified sites (198.8) 153, 162, 172 (M), 174 (F), 183 (F), 185
(M), 188 (M).------------------------------------------------------------------------
(b) DOL will select the site producing the highest estimate for probability of causation to adjudicate the claim.