Brain Molecular Markers
Description
Multiple brain molecular markers have become standard pathology components necessary for diagnosis. This data item captures clinically important brain cancer subtypes identified by molecular markers that are not distinguishable by ICD-O-3 codes.
Only one code is applicable for each tumor.
* *IDH mutation status* distinguishes between clinically important subtypes within ICD-O-3 **9400/3**, Diffuse astrocytoma and **9401/3**, Anaplastic astrocytoma.
* *IDH mutant and 1p/19q co-deletion* distinguishes between clinically important subtypes within ICD-O-3 code **9450/3**, Oligodendroglioma and **9451/3**, Anaplastic Oligodendroglioma.
* *IDH-wildtype* distinguishes clinically important subtypes within ICD-O-3 **9400/3**, Diffuse astrocytoma, **9401/3**, Anaplastic astrocytoma and **9440/3**, Glioblastoma, Epithelioid glioblastoma and Glioblastoma, NOS (note that the new ICD-O-3 code **9445/3** applies to Glioblastoma, IDH-mutant; information regarding this subtype is not collected using this data item).
* *SHH-activation and TP53-wildtype* distinguishes between clinically important subtypes within ICD-O-3 histology code **9471/3**, Medulloblastoma.
* *C19MC alteration status* distinguishes a clinically important highly aggressive subtype within ICD-O-3 **9478/3**, Embryonal tumor with multilayered rosettes.
Rationale
Collection of these clinically important brain cancer subtypes has been recommended by CBTRUS.
Additional Info
**Source documents:** pathology report
For further information, refer to the **Central Nervous System** cancer protocol published by the College of American Pathologists
Notes
**Note:** **Physician statement**
* Physician statement of histologic subtype can be used to code this data item when no other information is available.
Coding Guidelines
**1)** **Codes 01-09** are for specific ICD-O-3 codes
**2)** **Code 85** when histology is **NOT** 9400/3, 9401/3, 9440/3, 9450/3, 9451/3, 9471/3 and 9478/3
* **a.** This includes microscopically or non-microscopically confirmed cases
**3)** **Code 86** when there is a **Benign (/0)** or **Borderline (/1)** tumor
* **a.** This includes microscopically or non-microscopically confirmed cases
**4)** **Code 99** when
* **a.** Histology is 9400/3, 9401/3, 9440/3, 9450/3, 9451/3, 9471/3 and 9478/3
* **b.** **AND** there is no microscopic confirmation
***Examples:***
1. Biopsy of brain tumor, microscopic confirmation diagnosis: Diffuse Astrocytoma (9400/3). Additional testing done, and IDH-mutant is identified. Code 01.
2. Biopsy of brain tumor, microscopic confirmation diagnosis: Anaplastic astrocytoma (9401/3). No further testing or results unknown. Code 99.
3. MRI of brain tumor, clinical diagnosis: glioblastoma. No further workup. Code 99.
4. Biopsy of brain tumor, microscopic confirmation diagnosis: Mixed glioma (9382/3). Code 85.
Default
88
Metadata
SSDI
| Code |
Description |
| 01 |
Diffuse astrocytoma, IDH-mutant (9400/3) |
| 02 |
Diffuse astrocytoma, IDH-wildtype (9400/3) |
| 03 |
Anaplastic astrocytoma, IDH-mutant (9401/3) |
| 04 |
Anaplastic astrocytoma, IDH-wildtype (9401/3) |
| 05 |
Glioblastoma, IDH-wildtype (9440/3) |
| 06 |
Oligodendroglioma, IDH-mutant and 1 p/19q co-deleted (9450/3) |
| 07 |
Anaplastic oligodendroglioma, IDH-mutant and 1p/19q co-deleted (9451/3) |
| 08 |
Medulloblastoma, SHH-activated and TP53-wildtype (9471/3) |
| 09 |
Embryonal tumor with multilayered rosettes, C19MC-altered (9478/3) |
| 85 |
Not applicable: Histology not 9400/3, 9401/3, 9440/3, 9450/3, 9451/3, 9471/3, 9478/3 |
| 86 |
Benign or borderline tumor |
| 87 |
Test ordered, results not in chart |
| 88 |
Not applicable: Information not collected for this case
(If this item is required by your standard setter, use of code 88 will result in an edit error.) |
| 99 |
Not documented in medical record
No microscopic confirmation
Brain molecular markers not assessed or unknown if assessed |
