**Note 1:** Clinical grade must not be blank.
**Note 2:** Assign the highest grade from the primary tumor assessed during the clinical time frame.
**Note 3:** Code 1 for stated as “low grade” only.
**Note 4:** Codes 1-3 take priority over H.
**Note 5:** G3 includes undifferentiated and anaplastic.
**Note 6:** Code 9 when
* Grade from primary site is not documented
* Clinical workup is not done (for example, cancer is an incidental finding during surgery for another condition)
* Grade checked “not applicable” on CAP Protocol (if available) and no other grade information is available
**Note 7:** If there is only one grade available and it cannot be determined if it is clinical, pathological, or after neo-adjuvant therapy, assign as a clinical grade and code unknown (9) for pathological grade, and blank for post-therapy grade.
**Note 8:** If you are assigning an AJCC 8th edition stage group
* Grade is required to assign stage group
* Code H is treated as a G3 when assigning AJCC stage group
* An unknown grade may result in an unknown stage group