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 or pathological, assume it is a clinical grade and code appropriately per clinical grade categories for that site, and then code unknown (9) for pathological grade, and blank for post therapy grade.

Default

9

NAACCR Item

NAACCR #3843

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