Current RMA Instruments
| Reasonable Hypothesis SOP | 9 of 2020 |
| Balance of Probabilities SOP | 10 of 2020 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 147
- ICD-10-AM Codes: C11
Brief description
Malignant neoplasm of the nasopharynx is a primary malignancy of the mucosa (lining) of the nasopharynx, which is the space above the soft palate, at the back of the nose.
Confirming the diagnosis
Confirmation of the diagnosis requires histology (from a biopsy or surgical specimen).
The relevant medical practitioner is an Ear, Nose and Throat surgeon.
Additional diagnoses covered by SOP
- squamous cell carcinoma of the nasopharynx
- lymphoepithelioma (obsolete term for nasopharyngeal carcinoma)
- nasopharyngeal carcinoma
- undifferentiated carcinoma of the nasopharynx
Conditions not covered by SOP
- carcinoid tumour of nasopharynx#
- Hodgkin’s lymphoma of the nasopharynx*
- malignant neoplasm of the oropharynx or hypopharynx*
- malignant neoplasm of the sinus (maxillary, ethmoid, frontal or sphenoidal)#
- non-Hodgkin’s lymphoma of the nasopharynx*
- soft tissue sarcoma of the nasopharynx*
- secondary/metastatic cancer/carcinoma involving the nasopharynx (code to primary cancer site)
* another SOP applies
# non-SOP condition
Clinical onset
The most common presenting complaints are headache, diplopia, or facial numbness, caused by cranial nerve involvement, and a mass in the neck, due to cervical node metastases. Nasal obstruction with epistaxis may also occur. Once diagnosis has been confirmed, it may be possible to backdate clinical onset to when relevant symptoms first developed.
Clinical worsening
The only worsening factor is for inability to obtain appropriate clinical management. Specialist advice will generally be required to determine if worsening due to such inability has occurred.