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 codes A-D.
**Note 4:** The Fuhrman grade is no longer used for coding grade for Kidney cancers. The WHO/ISUP grade is now used. If the Fuhrman grade is documented, code 9.
**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 |
G1: Nucleoli absent or inconspicuous and basophilic at 400x magnification |
| 2 |
G2: Nucleoli conspicuous and eosinophilic at 400x magnification, visible but not prominent at 100x magnification |
| 3 |
G3: Nucleoli conspicuous and eosinophilic at 100x magnification |
| 4 |
G4: Marked nuclear pleomorphism and/or multinucleate giant cells and/or rhabdoid and/or sarcomatoid differentiation |
| A |
Well differentiated |
| B |
Moderately differentiated |
| C |
Poorly differentiated |
| D |
Undifferentiated, anaplastic |
| 9 |
Grade cannot be assessed (GX); Unknown |
