Secondary and unspecified malignant neoplasm of lymph nodes of multiple sites

This code signifies the presence of metastatic cancer in lymph nodes located in multiple, distinct anatomical regions throughout the body. It indicates that the primary tumor site is either unknown or has already been coded separately. This diagnosis confirms widespread lymphatic involvement by a malignant process.

Apply this code when documentation clearly states metastatic carcinoma to lymph nodes in multiple sites, and the primary site is either not yet identified or has been previously coded. This is appropriate for advanced-stage cancers where lymphatic spread is extensive. Documentation should specify "multiple sites" or list several distinct lymph node regions involved.

• Do not use if only a single lymph node region is involved; use a more specific code for that site.
• Always sequence this code after the primary malignancy code, if known.
• Ensure documentation explicitly states "secondary" or "metastatic" and "multiple sites" for accurate assignment.