**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:** The grading system for this chapter is based on histology
* Immature teratomas and serous carcinomas, codes L and H
* All other histologies: Code 1-3 if a nuclear grade is documented, otherwise code 9.
* If your registry collects ovarian borderline tumors (/1), code "B" for grade.
**Note 4:** G3 includes anaplastic.
**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.