Grade Clinical
Notes
**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:** Codes 1-4 take priority over A-D, L and H.
**Note 4:** CNS WHO classifications use a grading scheme that is a “malignancy scale” ranging across a wide variety of neoplasms rather than a strict histologic grading system that can be applied equally to all tumor types.
* Code the WHO grading system for selected tumors of the CNS as noted in the AJCC 8th edition Table 72.2 where WHO grade is not documented in the record
**Note 5:** 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 6:** 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.
Default
9
Metadata
SSDI
| Code |
Description |
| 1 |
WHO Grade I : Circumscribed tumors of low proliferative potential associated with the possibility of cure following resection |
| 2 |
WHO Grade II: Infiltrative tumors with low proliferative potential with increased risk of recurrence |
| 3 |
WHO Grade III: Tumors with histologic evidence of malignancy, including nuclear atypia and mitotic activity, associated with an aggressive clinical course |
| 4 |
WHO Grade IV: Tumors that are cytologically malignant, mitotically active, and associated with rapid clinical progression and potential for dissemination |
| L |
Stated as “low grade” NOS |
| H |
Stated as “high grade” NOS |
| A |
Well differentiated |
| B |
Moderately differentiated |
| C |
Poorly differentiated |
| D |
Undifferentiated, anaplastic |
| 9 |
Grade cannot be assessed (GX); Unknown |
