StacksVerified U.S. regulatory reference

42 CFR §81.21

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov
  1. (a)DOL will calculate probability of causation for all cancers using NIOSH-IREP.
  2. (b)Carcinoma in situ (ICD-10-CM codes D00-D09), neoplasms of uncertain behavior (ICD-10-CM codes D37-D44 and D48), and neoplasms of unspecified nature (ICD-10-CM code D49) are assumed to be malignant, for purposes of estimating probability of causation.
  3. (c)All secondary and unspecified cancers of the lymph node (ICD-10-CM codes C77 and C7B.01) shall be considered secondary cancers (cancers resulting from metastasis of cancer from a primary site). For claims identifying cancers of the lymph node, Table 1 in § 81.23(a) provides guidance for assigning a primary site and calculating probability of causation using NIOSH-IREP.